title: A decade of experience with transthoracic and transhiatal esophagectomy.
abstract: BACKGROUND
  Morbidity and mortality remain significant for transthoracic (TT) and transhiatal (TH) esophagectomy. We report a case-specific approach employing either resection to minimize perioperative morbidity and mortality.
  
  
  METHODS
  All primary esophageal resections performed for benign and malignant esophageal disease were reviewed over a 10-year period. The operative approach was tailored to the location and extent of disease and the physiologic reserve of the patient.
  
  
  RESULTS
  In all, 115 patients underwent esophagectomy for benign (25) and malignant (90) disease. Fifty-six TT and 59 TH resections were performed. Four emergent TT cases did not have reconstruction. There was 1 hospital mortality. Perioperative transfusion was avoided in 65 patients. Respiratory complications occurred in 15. Three patients had a cervical anastomotic leak requiring open wound drainage. No association between resection type and complication was evident.
  
  
  CONCLUSIONS
  The judicious use of both TT and TH esophagectomy resulted in an operative mortality of less than 1%, reduced operative blood loss, and a relatively low rate of perioperative complications.
authors.affiliation: Department of Surgery, Division of Thoracic and Cardiovascular Surgery, University of Louisville School of Medicine, 201 Abraham Flexner Way, #1200, Louisville, KY 40202, USA. Bousamra@louisville.edu
authors.forename: Michael
authors.initials: M
authors.lastname: Bousamra
authors.forename: George B
authors.initials: GB
authors.lastname: Haasler
authors.forename: Maryam
authors.initials: M
authors.lastname: Parviz
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D003964:Diaphragm; D004935:Esophageal Diseases / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000601:surgery; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D016019:Survival Analysis; D013909:Thorax; D016896:Treatment Outcome