Laparoscopic transhiatal esophagectomy: outcomes.
BACKGROUND
Laparoscopic transhiatal esophagectomy, indicated for benign and malignant esophageal diseases, is a complex operation, often associated with a high rate of morbidity and mortality. During the past decade this technique has became well accepted among specialized surgeons for the treatment of esophageal cancer, avoiding thoracotomy and reducing open access complications. The aim of the present study was to retrospectively analyze patients with esophageal cancer who underwent laparoscopic transhiatal esophagectomy.


METHODS
From November 1993 to August 2006, 78 patients underwent laparoscopic transhiatal esophagectomy. There were 68 cases of esophageal cancer (57 males and 21 females, age range = 28-73 years) with a predominant rate of squamous cell carcinoma (60.2%).


RESULTS
The conversion rate was 6.4%. The mean operative time was 153 min with a 12.8% rate of cervical leak and a postoperative (30-day) mortality rate of 5.1%. The four-year survival rate was 19% as determined within a subgroup of 21 patients whose followup during the period was possible.


CONCLUSIONS
Laparoscopic transhiatal esophagectomy is a safe alternative for experienced professionals. This access can improve mortality, hospital stay, and other outcomes when compared with open methods.
Tinoco
Renam
R
Department of Surgery, Hospital São José do Avaí, Itaperuna, Rio de Janeiro, Brazil. rctinoco@uol.com.br
El-Kadre
Luciana
L
Tinoco
Augusto
A
Rios
Rodrigo
R
Sueth
Daniela
D
Pena
Felipe
F
D000230:Adenocarcinoma; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged