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[Late morbidity after esophagectomy for cancer: is partial esophagectomy preferred?]
1Service de chirurgie digestive, centre hospitalier universitaire Purpan, Toulouse, France.
Purpose:
The aim of this study is to report late postoperative complications occurring after oesophagectomy for cancer over a 12-month period and to compare the incidence of these complications according to the level of the anastomosis.
Patients And Method:
This study included 106 consecutive patients 51% with subtotal oesophagectomy (thoracic anastomosis), and 49% with total oesophagectomy (cervical anastomosis). The two groups were comparable for age, mean weight loss before surgery, life expectancy, number of positive margins, TNM grading, size and tumour differentiation.
Results:
Late morbidity concerned 67.9% of the 106 patients. Predominant complications were dysphagia (32.1% of the 106), gastro-esophageal reflux (25.5% of the 106), and diarrhoea (18.8% of the 106). Among all the factors causing dysphagia, evaluated by logistic regression, the level of anastomosis was only found significant with a 20.4% occurrence for thoracic anastomosis and 44.2% for cervical anastomosis (P = 0.012). All the other complications were similar in the two groups.
Conclusion:
Functional results of oesophagectomy for cancer are poor. As partial oesophagectomy morbidity is lower, total oesophagectomy should not be proposed in all cases of oesophageal cancer.