The influence of preoperative radiation therapy on morbidity and mortality for transhiatal esophagectomy.
To assess the morbidity and mortality of preoperative radiation therapy (RT), the authors reviewed 37 consecutive patients who underwent transhiatal esophagectomy for carcinoma of the esophagus. Twelve patients received no RT, 13 patients received RT only to the neck, and 12 received RT to the chest (three of these received radiation therapy to the chest and neck). Preoperative chest RT did not significantly increase postoperative fistula formation but was associated with significantly higher operative mortality, overall complication rate, and time on ventilators than either the patients receiving neck RT alone or no RT (P less than 0.05). Postoperative hospital stay was longer and intraoperative blood loss greater for the chest RT group compared to those with no RT (P less than 0.05). Neck RT did not result in these complications (P = NS). The authors conclude that preoperative chest RT is associated with significant postoperative morbidity and mortality.
Tribble
C G
CG
Department of Surgery, University of Virginia Health Sciences Center, Charlottesville 22908.
Flanagan
T L
TL
Christensen
C P
CP
Daniel
T M
TM
Kron
I L
IL
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery; D004937:Esophageal Fistula / Q000209:etiology; D004938:Esophageal Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011300:Preoperative Care; D011708:Pylorus / Q000601:surgery; D011879:Radiotherapy Dosage; D013270:Stomach / Q000601:surgery; D015996:Survival Rate; D014768:Virginia / Q000453:epidemiology