Esophagogastrectomy: a consecutive single-center series.
We present a 7-year consecutive, nonselected, single-center series of patients (n = 140) submitted to surgery for esophageal or upper gastric malignancy. Follow-up data are complete for 96.4% of patients. Of 114 intrathoracic anastomoses, 74 (65%) were esophagogastric and 40 (35%) were esophagojejunal. Unresectable lesions were present in 26 (19%) patients. Age (mean +/- sd 64.6 +/- 11.1 years), and sex distribution were similar in all groups, while 36% of patients were over 70 years. There was no significant difference in the time from the onset of symptoms to presentation between the groups (p < 0.05). The values of admission hemoglobin, serum albumin, PaO2 or peak expiratory flow rate did not correlate with survival. There was no significant difference in 30-day operative mortality between the three procedures - esophagectomy 5%, thoraco-abdominal gastrectomy 10.8% and unresectable 11.5% (p > 0.05). The incidence of respiratory complications was the same whether a right (30%) or left (35%) thoracotomy was performed. Some 33% of patients were discharged from hospital after 14 days and 72% after 21 days (12.9% died in hospital). One-year survival was 33.4% for esophagectomy, 37.5% for total gastrectomy and 6% for unresectable lesions. The esophagectomy versus total gastrectomy survival curves were not significantly different, but there was a significant survival advantage when patients undergoing esophagectomy were compared with those who had unresectable tumors (0.02 > p > 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
de Gara
C J
CJ
Department of Surgery, Central Middlesex Hospital, London, U.K.
Payne-James
J J
JJ
Silk
D B
DB
Misiewicz
J J
JJ
Menzies-Gow
N
N
D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000601:surgery; D004938:Esophageal Neoplasms / Q000401:mortality / Q000601:surgery*; D016629:Esophagectomy; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008131:London / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome