Morbidity, ability to swallow, and survival, after oesophagectomy for cancer of the oesophagus and cardia.
OBJECTIVE
To study survival, morbidity, and ability to swallow, after oesophagectomy for cancer of the oesophagus and cardia.


METHODS
Prospective open study.


METHODS
University hospital, Norway.


METHODS
83 patients, 38 with squamous cell carcinoma and 45 with adenocarcinoma of the oesophagus and cardia.


METHODS
Transhiatal (n = 51) and transthoracic (n = 32) oesophagectomy. Oesophageal replacement was by either stomach (n = 80) or colon (n = 3). Cervical anastomosis was used in all but 2.


METHODS
Early and late morbidity and mortality, length of stay in intensive care unit and in hospital, and survival analysis.


RESULTS
30 Day and in hospital mortality were 0 and 4% for transhiatal, and 6% and 9% for transthoracic, oesophagectomy. Complications included recurrent nerve palsy (n = 7), anastomotic leaks (n = 5), and chylothorax (n = 4). 17 Patients (22%) needed dilatations for stenosis of the anastomosis, and 71 (85%) of the patients left hospital within four weeks of operation. Survival analysis showed a 5 year survival rate of 33% for patients with adenocarcinoma operated on for cure and a 2 year survival of 28% for patients with squamous cell carcinoma.


CONCLUSIONS
Oesophagectomy for cure is worthwhile as some patients are cured and most of the remainder have prolonged relief of their dysphagia. Palliative resections should not be done in patients with distant metastases or invasion of adjacent organs by the tumour because of long stay in hospital, appreciable morbidity, and short life expectancy.
Svanes
K
K
Department of Surgery, University of Bergen, Norway.
Stangeland
L
L
Viste
A
A
Varhaug
J E
JE
Grønbech
J E
JE
Søreide
O
O
D000230:Adenocarcinoma / Q000601:surgery*; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D002299:Cardia; D003679:Deglutition; D004938:Esophageal Neoplasms / Q000401:mortality / Q000601:surgery*; D016629:Esophagectomy / Q000401:mortality; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011183:Postoperative Complications; D011184:Postoperative Period; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000601:surgery*; D016019:Survival Analysis