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A decade of experience with transthoracic and transhiatal esophagectomy

Authors
  • Bousamra, Michael II
  • Haasler, George B
  • Parviz, Maryam
Type
Published Article
Journal
The American Journal of Surgery
Publisher
Elsevier
Publication Date
Jan 01, 2002
Volume
183
Issue
2
Pages
162–167
Identifiers
DOI: 10.1016/S0002-9610(01)00861-3
Source
Elsevier
Keywords
License
Unknown

Abstract

Background: Morbidity and mortality remain significant for transthoracic (TT) and transhiatal (TH) esophagectomy. We report a case-specific approach employing either resection to minimize perioperative morbidity and mortality. Methods: All primary esophageal resections performed for benign and malignant esophageal disease were reviewed over a 10-year period. The operative approach was tailored to the location and extent of disease and the physiologic reserve of the patient. Results: In all, 115 patients underwent esophagectomy for benign (25) and malignant (90) disease. Fifty-six TT and 59 TH resections were performed. Four emergent TT cases did not have reconstruction. There was 1 hospital mortality. Perioperative transfusion was avoided in 65 patients. Respiratory complications occurred in 15. Three patients had a cervical anastomotic leak requiring open wound drainage. No association between resection type and complication was evident. Conclusions: The judicious use of both TT and TH esophagectomy resulted in an operative mortality of less than 1%, reduced operative blood loss, and a relatively low rate of perioperative complications.

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