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World Journal of Surgical Oncology

, 6:88

First Online: 20 August 2008Received: 28 April 2008Accepted: 20 August 2008

Abstract

BackgroundThe optimal operative approach for carcinoma at the lower esophagus and esophagogastric junction remains controversial. The aim of this study was to assess a single unit experience of transhiatal esophagectomy in an era when the use of systemic oncological therapies has increased dramatically.

Study DesignBetween January 2000 and November 2006, 215 consecutive patients 182 males, 33 females, median age = 65 years underwent transhiatal esophagectomy; invasive malignancy was detected preoperatively in 188 patients. 90 patients 42% received neoadjuvant chemotherapy. Prospective data was obtained for these patients and cross-referenced with cancer registry survival data.

ResultsThere were 2 in-hospital deaths 0.9%. Major complications included: respiratory complications in 65 patients 30%, cardiovascular complications in 31 patients 14% and clinically apparent anastomotic leak in 12 patients 6%. Median length of hospital stay was 14 days. The radicality of resection was inversely related to T stage: an R0 resection was achieved in 98–100% of T0-1 tumors and only 14% of T4 tumors. With a median follow up of 26 months, one and five year survival rates were estimated at 81% and 48% respectively.

ConclusionTranshiatal esophagectomy is an effective operative approach for tumors of the infracarinal esophagus and the esophagogastric junction. It is associated with low mortality and morbidity and a five survival rate of nearly 50% when combined with neoadjuvant chemotherapy.

Electronic supplementary materialThe online version of this article doi:10.1186-1477-7819-6-88 contains supplementary material, which is available to authorized users.

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Autor: Andrew R Davies - Matthew J Forshaw - Aadil A Khan - Alia S Noorani - Vanash M Patel - Dirk C Strauss - Robert C Mas

Fuente: https://link.springer.com/







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