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Esophagogastrectomy via left thoracophrenotomy.
R D Page1, J F Khalil, R I Whyte
1Regional Adult Cardiothoracic Unit, Broadgreen Hospital, Liverpool, England.
The Annals of Thoracic Surgery
|May 1, 1990
Summary
The left thoracophrenotomy approach for esophagogastrectomy offers a viable surgical option for esophageal and gastric cardia tumors. This study reviews 115 patients, detailing outcomes and complications associated with this technique.
Area of Science:
- Surgical Oncology
- Gastrointestinal Surgery
- Thoracic Surgery
Background:
- Esophagogastrectomy is the standard treatment for resectable esophageal tumors.
- Various surgical approaches exist, each with distinct advantages and disadvantages.
Purpose of the Study:
- To evaluate the efficacy and outcomes of the left thoracophrenotomy approach for esophagogastrectomy.
- To analyze perioperative mortality, complications, and survival rates in patients undergoing this procedure.
Main Methods:
- Retrospective review of 115 patients who underwent esophagogastrectomy using a left thoracophrenotomy approach since April 1983.
- Utilized stapling instruments for gastric mobilization and esophagogastric anastomosis.
- Compared outcomes with a smaller cohort of 22 patients treated with alternative methods.
Main Results:
- Perioperative mortality rate was 8.7% (10/115).
- Anastomotic leakage occurred in 1.7% (2/115) of patients.
- Benign anastomotic narrowing affected 16 patients; 3-year survival was 22.1%.
Conclusions:
- The left thoracophrenotomy approach is a feasible technique for esophagogastrectomy, particularly for lower esophageal and gastric cardia lesions.
- While associated with specific complication rates, it offers a defined surgical pathway.
- Further investigation into optimizing outcomes and patient selection for this approach is warranted.