Esophagogastrectomy: reoperation for complications.
From 1961 to 1991, a total of 1,452 esophagectomies were performed for esophageal cancer at Memorial Sloan-Kettering Cancer Center. Of these patients, 40 (2.7%) developed complications requiring a second operation during the same hospitalization. The majority of the carcinomas were located in the midesophagus or the gastroesophageal junction. The pathologic diagnosis was squamous cell carcinoma in two-thirds of the patients. Few comorbid factors could be identified. Twenty-nine patients (72%) had a standard Ivor-Lewis resection, 5 (12%) had a transhiatal resection, 5 (12%) had a transabdominal approach, and 1 (3%) had a cervical approach only. Complications requiring reoperation were the following: respiratory failure in 13 patients, anastomotic leak in 6, bowel obstruction in 5, major bleeding in 4, wound dehiscence in 4, tracheo-esophageal fistula in 3, feeding tube malposition in 2, empyema in 1, chyle leak in 1, a positive margin in 1. Twelve of these same patients had a persistent or second complication and required a third operation. Among the 40 patients in this study, the mortality was 40%.
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York 10021.
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Matory
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Burt
D000230:Adenocarcinoma / Q000150:complications / Q000401:mortality / Q000601:surgery; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000401:mortality / Q000601:surgery; D004938:Esophageal Neoplasms / Q000150:complications / Q000401:mortality / Q000601:surgery; D016629:Esophagectomy / Q000401:mortality; D005743:Gastrectomy / Q000401:mortality; D006801:Humans; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000150:complications / Q000401:mortality / Q000601:surgery; D011183:Postoperative Complications / Q000401:mortality / Q000601:surgery*; D012086:Reoperation / Q000401:mortality