Comparison of conventional Lewis-Tanner two-stage oesophagectomy with the synchronous two-team approach.
Twenty-seven patients with oesophageal carcinoma had subtotal oesophagectomy by the Lewis-Tanner operation (group 1, n = 14) or a synchronous modification (group 2, n = 13). Synchronous operations were completed more quickly (230 versus 305 min, P < 0.01), but with more time spent under single-lung anaesthesia (160 versus 120 min, P < 0.01) and a greater fall in systolic blood pressure during hiatal manipulation (60 versus 30 mmHg, P < 0.01). Operative blood loss was not significantly greater in group 2, but the total volume of blood transfused in the perioperative period was greater in this group (5 versus 3 units, P < 0.01). Four patients in group 1 suffered significant postoperative complications, compared with seven in group 2; three postoperative deaths occurred in group 2. This study suggests that the synchronous two-team oesophagectomy produces a higher incidence of complications than the conventional operation. Continued use of the Lewis-Tanner two-stage oesophagectomy is recommended for patients with carcinoma of the oesophagus.
Hayes
N
N
Department of Surgical Gastroenterology, Newcastle General Hospital, Newcastle upon Tyne, UK.
Shaw
I H
IH
Raimes
S A
SA
Griffin
S M
SM
D000230:Adenocarcinoma / Q000601:surgery*; D000328:Adult; D000368:Aged; D000758:Anesthesia; D016063:Blood Loss, Surgical; D001794:Blood Pressure; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D017558:Elective Surgical Procedures; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D013997:Time Factors