Preoperative computed tomography for transhiatal esophagectomy.

Area of Science:

• Oncology
• Radiology
• Surgical Oncology

Background:

• Esophageal carcinoma presents a significant oncological challenge.
• Transhiatal esophagectomy offers lower morbidity and mortality compared to thoracotomy.
• Accurate preoperative staging is crucial for selecting the appropriate surgical approach.

Purpose of the Study:

• To evaluate the diagnostic performance of preoperative chest computed tomography (CT) in patients with esophageal carcinoma.
• To determine the utility of CT in identifying adjacent organ involvement, a contraindication for transhiatal esophagectomy.
• To assess the reliability of CT in predicting tracheobronchial invasion during transhiatal esophagectomy.

Main Methods:

• Retrospective analysis of 50 consecutive patients with surgically confirmed esophageal carcinoma.
• Review of preoperative chest CT scans to assess for adjacent organ involvement and tracheobronchial invasion.
• Correlation of CT findings with surgical outcomes and pathological reports.

Main Results:

• CT demonstrated 90% sensitivity and 92% specificity in detecting adjacent organ involvement.
• The negative predictive value of CT for tracheobronchial invasion was 90%.
• A negative preoperative CT scan was a reliable indicator for proceeding with transhiatal esophagectomy.

Conclusions:

• Preoperative chest CT is a valuable tool in the management of esophageal carcinoma.
• CT imaging aids in surgical planning by accurately identifying contraindications for transhiatal esophagectomy.
• Negative CT findings reliably predict the absence of major surgical risks, supporting the use of transhiatal esophagectomy.