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Esophageal resection by cervico-abdominal approach without thoracotomy
E Moreno González1, I González-Pinto, I García García
1General and Digestive Surgery Service C, Hospital 12 de Octubre, Madrid, Spain.
Surgery Today
|January 1, 1992
Summary
Transhiatal esophageal resection was performed for various conditions, primarily esophageal cancer. Survival rates varied by cancer type, with gastric cardia cancer showing better outcomes than esophageal cancer.
Area of Science:
- Surgery
- Gastroenterology
- Oncology
Background:
- Transhiatal esophageal resection is a complex surgical procedure.
- Experience with this procedure accumulated over a significant period provides valuable data.
Purpose of the Study:
- To report the experience with transhiatal esophageal resection.
- To analyze indications, methods, outcomes, and survival rates.
Main Methods:
- Retrospective review of patients undergoing transhiatal esophageal resection between January 1978 and March 1990.
- Analysis of indications, reconstructive techniques, complications, mortality, and survival data.
Main Results:
- Cancer represented the majority of indications (89.3%), often diagnosed at advanced stages.
- Tubulized stomach was the most common esophageal substitution (63.6%).
- Operative mortality was 5.8%, with respiratory and septic complications being primary causes of death. Five-year survival rates were 48.5% for gastric cardia cancer, 57.1% for hypopharyngeal cancer, and 11.8% for esophageal cancer.
Conclusions:
- Transhiatal esophageal resection is associated with significant morbidity and mortality, particularly in advanced cancers.
- Improved patient selection and perioperative management may be crucial for better outcomes.
- Long-term survival remains a challenge for esophageal cancer patients undergoing this procedure.