title: One hundred transhiatal esophagectomies: a single-institution experience.
abstract: BACKGROUND
  Surgery is considered the mainstay of treatment for esophageal carcinoma. Transhiatal esophagectomy with cervical esophagogastric anastomosis is considered relatively safe with an oncological outcome comparable to that using the transthoracic approach.
  
  
  OBJECTIVE
  To review the results of the first 100 transhiatal esophagectomies performed in a single Israeli center.
  
  
  METHODS
  The records of all patients who had undergone transhiatal esophagectomy during the period 2003-2009 were reviewed. The study group comprised the first 100 patients. All patients who had undergone colon or small bowel transposition were excluded. Indications for surgery included esophageal cancer, caustic injury and achalasia.
  
  
  RESULTS
  The median follow-up period was 19.5 months. The anastomotic leakage rate was 15% and all were managed successfully with local wound care. The benign stricture rate was 10% and all were managed successfully with endoscopic balloon dilation. Anastomotic leakage was found to be a risk factor for stricture formation. Overall survival was 54%. Response to neoadjuvant therapy was associated with a favorable prognosis.
  
  
  CONCLUSIONS
  Transhiatal esophagectomy is a relatively safe approach with adequate oncological results, as long as it is performed in a high volume center.
authors.affiliation: Department of Surgery B, Kaplan Medical Center, Rehovot, affiliated with Hebrew University-Hadassah Medical School, Jerusalem, Israel.
authors.forename: Guy
authors.initials: G
authors.lastname: Pines
authors.forename: Yoram
authors.initials: Y
authors.lastname: Klein
authors.forename: Ehud
authors.initials: E
authors.lastname: Melzer
authors.forename: Efraim
authors.initials: E
authors.lastname: Idelevich
authors.forename: Victor
authors.initials: V
authors.lastname: Buyeviz
authors.forename: Svetlana
authors.initials: S
authors.lastname: Machlenkin
authors.forename: Hanoch
authors.initials: H
authors.lastname: Kashtan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004935:Esophageal Diseases / Q000601:surgery*; D016629:Esophagectomy / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013997:Time Factors