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Updated: May 21, 2025

An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
Published on: April 17, 2020
[Surgical outcomes in patients with esophageal cancer in a third level center]
Edgar Joaquín Cortes-Torres1, Miguel Angel Reyna-Silva1, Alejandro González-Ojeda2
1Instituto Mexicano del Seguro Social, Centro Médico Nacional de Occidente, Hospital de Especialidades, Servicio de Cirugía Oncológica. Guadalajara, Jalisco, México.
Background:
Esophageal cancer is the seventh most diagnosed neoplasm, with a higher prevalence in men. Tobacco and alcohol consumption, gastroesophageal reflux disease, and Barrett's esophagus are associated with the development of adenocarcinoma and squamous cell carcinoma.
Objective:
To identify the clinical profile in patients with esophageal cancer at a tertiary care center.
Materials And Methods:
A cross-sectional, observational study. Patients with esophageal cancer were evaluated between January 2014 and July 2019. The study variables included sex, age, histological type, postoperative complications, mortality, and survival.
Results:
A total of 34 patients were evaluated, with a mean age of 61.8 ± 8.9 years. 88.2% were men. Tumor location was as follows: lower third (76.5%), middle third (17.6%), and upper third (5.9%). The most common histological types were adenocarcinoma (67.6%) and squamous cell carcinoma (32.4%). Symptoms included: dysphagia in 34 (100%) and epigastric pain in 20 (58.8%). The types of surgeries performed were: transhiatal in 15 (44.1%), palliative in 15 (44.1%), Ivor Lewis in 1 (2.9%), and McKeown in 1 (2.9%). Postoperative complications included: respiratory (29.4%), anastomotic leak (20.6%), sepsis (11.8%), and fistula (2.9%). Mortality was 13 (38.2%) patients, and survival at 22 months was 22%.
Conclusions:
Our study showed a higher prevalence of esophageal cancer in men over 60 years old with adenocarcinoma localized in the lower third of the esophagus. Despite chemotherapy treatment, patient survival remains poor due to late diagnosis in advanced stages of the disease, which limits tumor resectability and operability, leading to increased mortality.
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