Transthoracic versus transhiatal resection for carcinoma of the esophagus: a meta-analysis

• Published in: The Annals of Thoracic Surgery Vol. 72; no. 1; pp. 306 - 313
• Main Authors: Hulscher, Jan B.F, Tijssen, Jan G.P, Obertop, Hugo, van Lanschot, J.Jan B
• Format: Book Review Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.07.2001; Elsevier Science
• Subjects: Biological and medical sciences; Esophageal Neoplasms - mortality; Esophageal Neoplasms - surgery; Esophagectomy - methods; Esophagus; Hospital Mortality; Humans; Lymph Node Excision - methods; Medical sciences; Postoperative Complications - mortality; Randomized Controlled Trials as Topic; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Survival Rate; Thoracotomy - methods; Human; Carcinoma; Prognosis; Treatment efficiency; Mortality; Esophageal disease; Surgical resection; Thorax; Malignant tumor; Morbidity; Five year survival; Metaanalysis; Esophagus; Treatment; Surgery; Digestive diseases; Surgical approach; Diaphragm; Technique; Comparative study
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/S0003-4975(00)02570-4

There is much controversy about the surgical approach to esophageal carcinoma: should an extensive resection be done to optimize long-term survival or should the extent of the operation be limited to obtain lower perioperative morbidity and mortality rates? We systematically reviewed the English-language literature published during the past decade, with emphasis on the differences between transthoracic and transhiatal resections regarding early morbidity, in-hospital mortality rates, and 3- and 5-year survival. Although transthoracic resections had significantly higher early (pulmonary) morbidity and mortality rates, 5-year survival was approximately 20% after both transthoracic and transhiatal resections.