Esophagectomy for benign disease: trends in surgical results and management.
BACKGROUND
Esophagectomy for benign disease is uncommon.


METHODS
From July 1987 to April 1995, 45 consecutive patients (30 men, 15 women; mean age, 50 years) were evaluated in whom the senior author (R.F.H.) performed an esophagectomy, esophageal reconstruction, or both. The study period was divided into two time intervals, July 1987 to January 1992 (time 1) and February 1992 to April 1995 (time 2).


RESULTS
Indications for operation included obstruction (23 patients, 51%), benign neoplasia (17.38%), and perforation (5 patients, 11%). A nonthoracotomy approach was used in 19 (42%) patients: 15 transhiatal and 4 substernal. Thoracotomies were performed in 26 (58%) patients through a left thoracoabdominal or multiincisional techniques. Morbidity occurred in 15 (33%) patients, and there was one operative death (2%).


CONCLUSIONS
Despite an operative morbidity of 33%, esophagectomy for benign disease may be performed with acceptably low mortality. We observed the following trends: (1) an increase in patients with benign neoplasia and a decline in patients with obstruction, (2) an increased use of transhiatal esophagectomy, (3) a decreased use of colon, an increased use of stomach for esophageal replacement; and (4) a decreased length of hospital stay.
Davis
E A
EA
Department of General Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Heitmiller
R F
RF
D000293:Adolescent; D000328:Adult; D000368:Aged; D003106:Colon / Q000637:transplantation; D004935:Esophageal Diseases / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000601:surgery*; D004939:Esophageal Perforation / Q000601:surgery; D004940:Esophageal Stenosis / Q000601:surgery; D016629:Esophagectomy / Q000009:adverse effects / Q000639:trends; D004944:Esophagoplasty / Q000009:adverse effects; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D013249:Sternum / Q000601:surgery; D013270:Stomach / Q000637:transplantation; D015996:Survival Rate; D013908:Thoracotomy / Q000009:adverse effects / Q000379:methods