Left thoracoabdominal esophagectomy: results from a single specialist center
SUMMARY The left thoracoabdominal approach to esophagectomy is not widely performed, despite offering excellent exposure to tumors of the esophagogastric junction. Criticisms of the approach have focused on historically high rates of mortality, complications, and positive resection margins. Our aim...
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Published in | Diseases of the esophagus Vol. 24; no. 3; pp. 138 - 144 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
Malden, USA
Blackwell Publishing Inc
01.04.2011
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Subjects | |
Online Access | Get full text |
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Summary: | SUMMARY
The left thoracoabdominal approach to esophagectomy is not widely performed, despite offering excellent exposure to tumors of the esophagogastric junction. Criticisms of the approach have focused on historically high rates of mortality, complications, and positive resection margins. Our aim was to determine whether left thoracoabdominal esophagectomy could combine a radical oncological resection with acceptably low mortality and morbidity. A retrospective cohort study of all left thoracoabdominal esophagectomies was performed at a single specialist center over an 11‐year period. Primary outcomes were in‐hospital mortality, complications, resection margin involvement, and lymph node yield; secondary outcomes were 1‐year and 5‐year survival. Two hundred eleven esophagectomies were performed. In‐hospital mortality was 5.7% (12/211). One hundred one subjects (47.9%) had an uncomplicated recovery; 110 subjects (52.1%) developed at least one complication. There were 15 clinically significant anastomotic leaks (7.1%). Twenty‐four subjects (11.4%) required emergency reoperation, the most common indication being anastomotic leakage. Complete tumor excision (R0 resection) was achieved in 151 of 211 cases (71.6%); median lymph node yield was 24. One‐year and 5‐year survival rates were 70% (147/211) and 21% (24/116), respectively. Left thoracoabdominal esophagectomy can combine a radical oncological resection with acceptably low mortality and morbidity. |
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Bibliography: | ArticleID:DOTE1107 istex:BF9C12808610D372266D72BCC75FAD9D0271CCD9 ark:/67375/WNG-63R0KWDG-6 All authors contributed to study design, writing of manuscript, and approval of final version for submission. RSG and AS were responsible for data collection. BS, REKM, and NDM were responsible for refinement and description of surgical technique. Contribution of authors ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 1120-8694 1442-2050 |
DOI: | 10.1111/j.1442-2050.2010.01107.x |