Transhiatal esophagectomy (THE)

Area of Science:

• Surgical Oncology
• Gastrointestinal Surgery
• Esophageal Cancer Treatment

Background:

• Transhiatal esophagectomy (THE) is a surgical technique for esophageal removal without thoracotomy.
• It involves abdominal and cervical approaches, pioneered by Orringer with extensive experience.
• THE is associated with lower morbidity compared to transthoracic esophagectomy.

Purpose of the Study:

• To evaluate the suitability of Transhiatal Esophagectomy (THE) for esophageal cancer.
• To compare the outcomes of THE with transthoracic approaches for esophageal cancer treatment.
• To analyze the role of surgical technique versus tumor biology in esophageal cancer prognosis.

Main Methods:

• Review of Transhiatal Esophagectomy (THE) technique and its application in esophageal cancer.
• Comparison of morbidity and survival data between THE and transthoracic esophagectomy.
• Analysis of factors influencing esophageal carcinoma outcomes, including tumor stage and systemic disease.

Main Results:

• THE demonstrates lower morbidity than transthoracic approaches.
• Controversy exists regarding THE's suitability for cancer due to lack of en-bloc lymphadenectomy.
• No significant statistical differences in overall outcomes were observed between THE and transthoracic approaches for esophageal cancer.

Conclusions:

• Transhiatal Esophagectomy (THE) is a viable surgical option for esophageal cancer, offering reduced morbidity.
• Tumor biology and stage are critical determinants of esophageal cancer prognosis, often outweighing surgical technique.
• Further research may clarify the role of lymphadenectomy in THE for specific cancer presentations.