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Transhiatal esophagectomy for benign and malignant disease
M B Orringer1, B Marshall, M C Stirling
1Department of Surgery, University of Michigan Medical Center, Ann Arbor 48109.
The Journal of Thoracic and Cardiovascular Surgery
|February 1, 1993
Summary
Transhiatal esophagectomy is a safe and effective procedure for intrathoracic esophageal diseases. This study shows good outcomes for both benign and malignant conditions, with high patient discharge rates.
Area of Science:
- Surgery
- Gastroenterology
- Thoracic Surgery
Background:
- Transhiatal esophagectomy is a surgical approach for diseases of the intrathoracic esophagus.
- It is used for both benign and malignant conditions, often in patients with prior esophageal operations.
Purpose of the Study:
- To evaluate the safety and efficacy of transhiatal esophagectomy in a large patient cohort.
- To assess outcomes including mortality, complications, functional results, and survival rates.
Main Methods:
- A retrospective review of 583 patients who underwent transhiatal esophagectomy.
- Analysis of patient demographics, indications for surgery, operative details, complications, and long-term outcomes.
Main Results:
- The procedure was successful in 97% of attempted cases, with 5% overall hospital mortality for both benign and malignant diseases.
- Complications included pleural entry (74%) and anastomotic leak (9%).
- Good functional results were achieved in nearly 70% of benign disease patients, and survival for carcinoma patients was comparable to transthoracic approaches.
Conclusions:
- Transhiatal esophagectomy is a feasible, safe, and well-tolerated option for esophageal resection in most patients.
- Careful patient selection and surgical technique are crucial for optimal outcomes.