title: Esophageal resection by cervico-abdominal approach without thoracotomy.
abstract: The authors report their experience with transhiatal esophageal resection accumulated during the period between January 1978 and March 1990. Indications for the procedure included cancer of the gastric cardia (26.3%), cancer of the hypopharynx (3.8%), cancer of the esophagus (59.2%), and benign esophageal disease (9.8%). Esophageal substitution was performed using a tubulized stomach (63.6%), ileo-ceco-coloplasty (28.5%), left colon (7.6%), and jejunum (0.3%). The majority of patients with neoplastic disease were found to be in an advanced stage (67.3% of esophageal cancer patients and 69.7% of cancer of the cardia patients with stage III disease). The mean intra-operative volume of blood transfused varied between 533 and 1,220 ml. Sixteen patients required hospitalization in the intensive care unit. The mean length of post-operative hospitalization varied between 16.8 and 20.6 days. Operative complications included hemorrhage (0.3%) and tracheal injury (0.6%). Operative (30 day) mortality was 5.8%. Causes of death included respiratory insufficiency (35.2%), pulmonary sepsis (23.5%), abdominal sepsis (17.8%), and others (undefined, 23.5%). The 5 year survival was 48.5% for cancer of the gastric cardia, 57.1% for cancer of the hypopharynx and 11.8% for esophageal cancer.
authors: General and Digestive Surgery Service C, Hospital 12 de Octubre, Madrid, Spain.
authors: E
authors: E
authors: Moreno González
authors: I
authors: I
authors: González-Pinto
authors: I
authors: I
authors: García García
authors: R
authors: R
authors: Gómez Sanz
authors: C
authors: C
authors: Loinaz Segurola
authors: J
authors: J
authors: Bercedo Martínez
authors: J
authors: J
authors: Figueroa Andollo
authors: F
authors: F
authors: Palma Carazo
authors: M
authors: M
authors: Marcello Fernández
mesh_terms: D000005:Abdomen; D000293:Adolescent; D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D001810:Blood Volume; D002299:Cardia / Q000601:surgery; D004935:Esophageal Diseases / Q000601:surgery; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D007431:Intraoperative Complications / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009333:Neck; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000401:mortality; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome