title: Total esophagogastrectomy plus extended lymphadenectomy with transverse colon interposition: A treatment for extensive esophagogastric junction cancer.
abstract: OBJECTIVE
  To review the post-operative morbidity and mortality of total esophagogastrectomy (TEG) with second barrier lymphadenectomy (D2) with interposition of a transverse colon and to determine the oncological outcomes of TEG D2 with interposition of a transverse colon.
  
  
  METHODS
  This study consisted of a retrospective review of patients with a cancer diagnosis who underwent TEG between 1997 and 2013. Demographic data, surgery protocols, complications according to Clavien-Dindo classifications, final pathological reports, oncological follow-ups and causes of death were recorded. We used the TNM 2010 and Japanese classifications for nodal dissection of gastric cancer. We used descriptive statistical analysis and Kaplan-Meier survival curves. A P-value of less than 0.05 was considered statistically significant.
  
  
  RESULTS
  The series consisted of 21 patients (80.9% men). The median age was 60 years. The 2 main surgical indications were extensive esophagogastric junction cancers (85.7%) and double cancers (14.2%). The mean total surgery time was 405 min (352-465 min). Interposition of a transverse colon through the posterior mediastinum was used for replacement in all cases. Splenectomy was required in 13 patients (61.9%), distal pancreatectomy was required in 2 patients (9.5%) and resection of the left adrenal gland was required in 1 patient (4.7%). No residual cancer surgery was achieved in 75.1% of patients. A total of 71.4% of patients had a postoperative complication. Respiratory complications were the most frequently observed complication. Postoperative mortality was 5.8%. Median follow-up was 13.4 mo. Surgery specific survival at 5 years of follow-up was 32.8%; for patients with curative surgery, it was 39.5% at 5 years.
  
  
  CONCLUSIONS
  TEG for cancer with interposition of a transverse colon is a very complex surgery, and it presents high post-operative morbidity and adequate oncological outcomes.
authors.affiliation: Marco Ceroni, Enrique Norero, Juan Pablo Henríquez, Eduardo Viñuela, Eduardo Briceño, Cristian Martínez, Gloria Aguayo, Alfonso Díaz, Mario Caracci, Department of Digestive Surgery, Pontificia Universidad Católica de Chile School of Medicine, Hospital Sótero del Rio, Puente Alto, Santiago 8207257, Chile.
authors.forename: Marco
authors.initials: M
authors.lastname: Ceroni
authors.affiliation: Marco Ceroni, Enrique Norero, Juan Pablo Henríquez, Eduardo Viñuela, Eduardo Briceño, Cristian Martínez, Gloria Aguayo, Alfonso Díaz, Mario Caracci, Department of Digestive Surgery, Pontificia Universidad Católica de Chile School of Medicine, Hospital Sótero del Rio, Puente Alto, Santiago 8207257, Chile.
authors.forename: Enrique
authors.initials: E
authors.lastname: Norero
authors.affiliation: Marco Ceroni, Enrique Norero, Juan Pablo Henríquez, Eduardo Viñuela, Eduardo Briceño, Cristian Martínez, Gloria Aguayo, Alfonso Díaz, Mario Caracci, Department of Digestive Surgery, Pontificia Universidad Católica de Chile School of Medicine, Hospital Sótero del Rio, Puente Alto, Santiago 8207257, Chile.
authors.forename: Juan Pablo
authors.initials: JP
authors.lastname: Henríquez
authors.affiliation: Marco Ceroni, Enrique Norero, Juan Pablo Henríquez, Eduardo Viñuela, Eduardo Briceño, Cristian Martínez, Gloria Aguayo, Alfonso Díaz, Mario Caracci, Department of Digestive Surgery, Pontificia Universidad Católica de Chile School of Medicine, Hospital Sótero del Rio, Puente Alto, Santiago 8207257, Chile.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Viñuela
authors.affiliation: Marco Ceroni, Enrique Norero, Juan Pablo Henríquez, Eduardo Viñuela, Eduardo Briceño, Cristian Martínez, Gloria Aguayo, Alfonso Díaz, Mario Caracci, Department of Digestive Surgery, Pontificia Universidad Católica de Chile School of Medicine, Hospital Sótero del Rio, Puente Alto, Santiago 8207257, Chile.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Briceño
authors.affiliation: Marco Ceroni, Enrique Norero, Juan Pablo Henríquez, Eduardo Viñuela, Eduardo Briceño, Cristian Martínez, Gloria Aguayo, Alfonso Díaz, Mario Caracci, Department of Digestive Surgery, Pontificia Universidad Católica de Chile School of Medicine, Hospital Sótero del Rio, Puente Alto, Santiago 8207257, Chile.
authors.forename: Cristian
authors.initials: C
authors.lastname: Martínez
authors.affiliation: Marco Ceroni, Enrique Norero, Juan Pablo Henríquez, Eduardo Viñuela, Eduardo Briceño, Cristian Martínez, Gloria Aguayo, Alfonso Díaz, Mario Caracci, Department of Digestive Surgery, Pontificia Universidad Católica de Chile School of Medicine, Hospital Sótero del Rio, Puente Alto, Santiago 8207257, Chile.
authors.forename: Gloria
authors.initials: G
authors.lastname: Aguayo
authors.affiliation: Marco Ceroni, Enrique Norero, Juan Pablo Henríquez, Eduardo Viñuela, Eduardo Briceño, Cristian Martínez, Gloria Aguayo, Alfonso Díaz, Mario Caracci, Department of Digestive Surgery, Pontificia Universidad Católica de Chile School of Medicine, Hospital Sótero del Rio, Puente Alto, Santiago 8207257, Chile.
authors.forename: Fernando
authors.initials: F
authors.lastname: Araos
authors.affiliation: Marco Ceroni, Enrique Norero, Juan Pablo Henríquez, Eduardo Viñuela, Eduardo Briceño, Cristian Martínez, Gloria Aguayo, Alfonso Díaz, Mario Caracci, Department of Digestive Surgery, Pontificia Universidad Católica de Chile School of Medicine, Hospital Sótero del Rio, Puente Alto, Santiago 8207257, Chile.
authors.forename: Paulina
authors.initials: P
authors.lastname: González
authors.affiliation: Marco Ceroni, Enrique Norero, Juan Pablo Henríquez, Eduardo Viñuela, Eduardo Briceño, Cristian Martínez, Gloria Aguayo, Alfonso Díaz, Mario Caracci, Department of Digestive Surgery, Pontificia Universidad Católica de Chile School of Medicine, Hospital Sótero del Rio, Puente Alto, Santiago 8207257, Chile.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Díaz
authors.affiliation: Marco Ceroni, Enrique Norero, Juan Pablo Henríquez, Eduardo Viñuela, Eduardo Briceño, Cristian Martínez, Gloria Aguayo, Alfonso Díaz, Mario Caracci, Department of Digestive Surgery, Pontificia Universidad Católica de Chile School of Medicine, Hospital Sótero del Rio, Puente Alto, Santiago 8207257, Chile.
authors.forename: Mario
authors.initials: M
authors.lastname: Caracci
keywords: Esophagogastric junction cancer; Total esophagectomy; Total esophagogastrectomy; Total gastrectomy; Transverse colon interposition