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Abdominocervical oesophagectomy in the elderly
Annals of the Royal College of Surgeons of England
|November 1, 1985
Summary
Transhiatal esophagectomy in 8 patients, including elderly individuals with esophageal cancer and those with achalasia, resulted in no deaths or leaks. Survivors experienced satisfactory swallowing, with one needing stricture dilation.
Area of Science:
- Gastroenterology and Surgical Oncology
- Thoracic Surgery
Background:
- Transhiatal esophagectomy is a surgical procedure for esophageal diseases.
- This study examines outcomes in a small cohort with diverse indications, including cancer and achalasia.
Purpose of the Study:
- To evaluate the safety and efficacy of abdominocervical (transhiatal) esophagectomy.
- To assess outcomes in elderly patients and those with complex conditions like recurrent achalasia and megaesophagus.
Main Methods:
- Abdominocervical (transhiatal) esophagectomy was performed on 8 patients.
- Patient indications included esophageal cancer, recurrent achalasia with megaesophagus, and unexpected findings during hernia repair.
Main Results:
- No operative deaths or anastomotic leaks occurred in the 8 patients.
- Chest complications were frequent, but 5 patients survived with satisfactory swallowing.
- Three patients died from recurrent cancer between 12 and 21 months post-surgery.
Conclusions:
- Transhiatal esophagectomy is a viable option with no mortality in this series, despite frequent chest complications.
- The procedure can be safely performed in elderly patients and those with complex esophageal conditions.
- Long-term survival depends on the underlying pathology, with cancer recurrence being a significant factor.