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Transhiatal esophagectomy.

N M Gupta1

  • 1Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Acta Chirurgica Scandinavica
|February 1, 1990
PubMed
Summary
This summary is machine-generated.

Transhiatal esophagectomy, a minimally invasive surgical approach for esophageal conditions, demonstrated reduced mortality and morbidity with increased surgeon experience. This technique offers advantages by avoiding thoracotomy, making it a safe and effective option.

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Thoracic Surgery

Background:

  • Esophageal cancer and corrosive strictures necessitate surgical intervention.
  • Traditional esophagectomy often involves thoracotomy, carrying significant risks.
  • Minimally invasive techniques are sought to improve patient outcomes.

Purpose of the Study:

  • To evaluate the safety and efficacy of transhiatal esophagectomy without thoracotomy.
  • To assess the short-term outcomes, including mortality and morbidity, of this surgical approach.
  • To identify the advantages and learning curve associated with transhiatal esophagectomy.

Main Methods:

  • Transhiatal esophagectomy was performed in 42 patients (40 with esophageal cancer, 2 with corrosive stricture).
  • The procedure involved a single-stage resection and esophagogastric anastomosis in the neck.

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  • Outcomes were monitored for 30-day mortality and various complications.

    • Main Results:

    • The 30-day mortality rate was 12%.
    • Common complications included pneumothorax (71%), transient hoarseness (19%), and anastomotic leak (17%).
    • Mortality and morbidity decreased as surgical experience with the technique grew.

    Conclusions:

    • Transhiatal esophagectomy without thoracotomy is a safe and well-tolerated procedure.
    • Key advantages include shorter operating times and avoidance of thoracotomy.
    • The procedure's safety and tolerability improve with accumulated surgical experience.