Transhiatal versus transthoracic esophagectomy for clinical stage I esophageal carcinoma

A study was carried out to compare the actuarial survival and postoperative mortality in two groups of the patients with Clinical Stage I esophageal carcinoma resected with or without intercostal thoracotomy.

Group 1 included twenty-one patients resected with a transhiatal approach and Group 2 had twenty patients resected with other transthoracic methods.

Neither the Kaplan-Meier nor the comparative Mantel-Haeszel test demonstrated a significant difference. Nevertheless the early postoperative deaths are higher in Group 2 than Group 1.

In spite of the incoherent relation between clinical and post-resection staging, we believe the transhiatal approach for clinical Stage I Esophageal carcinoma is a good decision, especially in patients with liver or bronchopulmonary associated damage. At present, we perform a laparoscopy in theater to check the liver and avoid "surprise cirrhosis".