Transhiatal esophagectomy for benign and malignant conditions.
BACKGROUND
Experience with transhiatal esophagectomy (THE) for both benign and malignant diseases of the esophagus as practiced over an 18-year period is presented.


METHODS
Between 1982 and 2000, 411 consecutive patients underwent THE for both benign (n = 44) and malignant (n = 367) diseases of esophagus. Surviving patients were followed up for a mean of 30.4 months.


RESULTS
The overall operative mortality was 11% which had reduced to 6% for the last 111 patients. Operative mortality in the benign group was less than 5%. Respiratory complications were the most frequent cause of morbidity and mortality. Nonfatal anastomotic leaks occurred in 14%. The overall actuarial survival rates at 2, 5, and 10 years for carcinoma patients were 54%, 38%, and 18% respectively. The 2- and 5-year actuarial survival rates for postcricoid cancers were 83% and 64%, respectively.


CONCLUSIONS
Transhiatal esophagectomy is safe and effective, and its results including long-term outcome are comparable with most published series.
Rao
Y Govardhan
YG
Department of Gastrointestinal Surgery and Liver transplantation, All India Institute of Medical Sciences, New Delhi, India.
Pal
Sujoy
S
Pande
G K
GK
Sahni
Peush
P
Chattopadhyay
Tushar K
TK
D000293:Adolescent; D000328:Adult; D001707:Biopsy, Needle; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D002648:Child; D015331:Cohort Studies; D018572:Disease-Free Survival; D004935:Esophageal Diseases / Q000401:mortality / Q000473:pathology / Q000601:surgery; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D004945:Esophagoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011336:Probability; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome