In:
Journal of Surgical Oncology, Wiley, Vol. 110, No. 3 ( 2014-09), p. 298-301
Abstract:
The surgical approach to esophageal cancer continues to be controversial. A transthoracic approach is often advocated for better oncologic staging and improved survival. A transhiatal approach is often preferred due to a perceived decreased operative morbidity and mortality. Methods Using the American College of Surgeons‐National Surgical Quality Improvement Project (ACS‐NSQIP) participant‐use file, patients were identified who underwent either a transhiatal or transthoracic esophagectomy for cancer at participating hospitals from 2005 to 2011. Demographic, clinical, intra‐operative variables, and 30‐day morbidity and mortality were collected. Results Of the 1,428 patients that had esophagectomy, 750 (52.5%) had a transhiatal (TH) resection and 678 (47.5%) had a transthoracic (TT) resection. The transhiatal group was older (66 vs. 63 years, P = 0.003) with a lower ASA class (2.84 vs. 2.91, P = 0.025). Operative time was greater in the TT group (364 vs. 298 min, P 〈 0.001). There was no significant difference in 30 day overall mortality (TH = 2.9%, TT = 4.7%, P = 0.095) however a trend favored the TH group. Serious morbidity remains clinically significant in both groups (TH = 39.6%, TT = 43.5%, P = 0.146). The TH group had a significantly higher superficial wound infection rate (11.6% vs. 6.2%, P 〈 0.001) while the TT group required more perioperative blood transfusions (12.5% vs. 8.9%, P = 0.032) and returns to operating room (14.5% vs. 10.9%, P = 0.046). Conclusion Serious morbidity continues to be high for both types of esophagectomy. There needs to be continued efforts to diminish these complications. J. Surg. Oncol. 2014 110:298–301 . © 2014 Wiley Periodicals, Inc.
Type of Medium:
Online Resource
ISSN:
0022-4790
,
1096-9098
Language:
English
Publisher:
Wiley
Publication Date:
2014
detail.hit.zdb_id:
1475314-5
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