Transhiatal oesophagectomy: techniques, tips and outcomes.
OBJECTIVE
To demonstrate our technique and valuable tips for transhiatal oesophagectomies.


METHODS
215 patients underwent transhiatal oesophagectomies in our unit between 2000 and 2006.


RESULTS
In-hospital mortality was 0.9%. Anastomotic leak in 12 patients (5.6%). Chyle leak was seen in five patients and recurrent nerve neuropraxia in six patients. Iatrogenic splenectomy rate was 6%. The median operative time was 151 minutes (range 93-276 minutes). Overall median length of hospital stay was 15 days (range 8-95 days). The median survival for all patients undergoing transhiatal oesophagectomy for invasive malignancy was 42.9 months and the one-year and five-year survival were 81% and 48% respectively.


CONCLUSIONS
This is a safe and oncologically sound procedure. We feel that the tips can be helpful for anyone performing this procedure.
Rohatgi
A
A
Department of General Surgery, Guy's and St Thomas' NHS Foundation Trust, St Thomas' Hospital, London, UK.
Forshaw
M J
MJ
Sutcliffe
R P
RP
Strauss
D C
DC
Mason
R C
RC
D000230:Adenocarcinoma / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000379:methods; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D004210:Dissection / Q000379:methods; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D013536:Suture Techniques; D016896:Treatment Outcome