title: [Transhiatal esophagus resection without thoracotomy for carcinoma: complications, hospital mortality and prognosis in 115 patients].
abstract: OBJECTIVE
  To evaluate the short-term and long-term clinical outcome of transhiatal oesophagectomy without thoracotomy for cancer.
  
  
  METHODS
  Retrospective.
  
  
  METHODS
  In the period January 1993-August 1996, 115 patients underwent a transhiatal oesophagectomy with curative intent for adenocarcinoma or squamous cell carcinoma of the middle or distal oesophagus or oesophagogastric junction. There were 87 men and 28 women with a median age of 65 years (range: 37-83). Median duration of postoperative follow-up was 27 months (range: 1-74) for all patients, and 45 months (range: 30-74) for those alive at final follow-up.
  
  
  RESULTS
  No emergency thoracotomies were necessary. In-hospital mortality was 3.5% (4 patients). Vocal cord dysfunction (24%) and pulmonary complications (23%) were the most frequent early postoperative complications. Clinical leakage of the cervical anastomosis occurred in 8 patients (7%). Forty per cent developed a benign anastomotic stricture which was treated by (repeated) endoscopic dilatation. A microscopically radical resection was achieved in 73% of the patients. Overall survival was 45% at 3 years.
  
  
  CONCLUSIONS
  Transhiatal oesophagectomy without thoracotomy can be considered a safe procedure for resectable cancer of the midoesophagus, the distal oesophagus or the oesophagogastric junction. Long-term oncological treatment results were in line with the data reported for oesophageal resections via a transthoracic approach.
authors.affiliation: Academisch Medisch Centrum, Amsterdam. j.w.vansandick@amc.uva.nl
authors.forename: J W
authors.initials: JW
authors.lastname: van Sandick
authors.forename: H
authors.initials: H
authors.lastname: Obertop
authors.forename: P
authors.initials: P
authors.lastname: Fockens
authors.forename: J
authors.initials: J
authors.lastname: Kesecioglu
authors.forename: L E
authors.initials: LE
authors.lastname: Overdijk
authors.forename: J J
authors.initials: JJ
authors.lastname: van Lanschot
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000601:surgery*; D000075202:Contraindications; D004938:Esophageal Neoplasms / Q000401:mortality / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D013908:Thoracotomy; D016896:Treatment Outcome