| Surgical management of esophageal cancer. A decade of change. | |
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MedLine Citation:
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PMID: 8185398 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To examine trends for use of transhiatal esophagectomy (THE) and to relate outcome variables to changes in use, controlling for preoperative risk. BACKGROUND: High operative morbidity and mortality rates are reported with conventional transthoracic esophagectomy (TTE). Transhiatal esophagectomy has been proposed as an alternative but is controversial. METHODS: In this retrospective study divided into early and late time periods, outcome variables were subjected to univariate and multivariate analyses. RESULTS: Use of THE increased significantly in the late period (p < 0.0001). Patients who had THE had significantly higher American Society of Anesthesiologists (ASA) risk scores (p < 0.001). By the late period, 92% of patients with ASA III/IV scores were resected by THE. Postoperative morbidity decreased significantly and operative mortality decreased from 15% to 0% (p < 0.01) between the early and late time periods. By multivariate analysis, ASA > or = III and TTE were associated with adverse surgical outcome. Pathologic stage determined disease-free survival, which was 37% at 3 years for all survivors. CONCLUSIONS: Increased use of THE results in better operative outcome and does not adversely affect disease-free survival. |
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Authors:
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J S Bolton; J L Ochsner; A A Abdoh |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Annals of surgery Volume: 219 ISSN: 0003-4932 ISO Abbreviation: Ann. Surg. Publication Date: 1994 May |
Date Detail:
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Created Date: 1994-06-14 Completed Date: 1994-06-14 Revised Date: 2009-11-18 |
Medline Journal Info:
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Nlm Unique ID: 0372354 Medline TA: Ann Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 475-80 Citation Subset: AIM; IM |
Affiliation:
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Department of Surgery, Ochsner Medical Institutions, Jefferson, Louisiana. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adenocarcinoma
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mortality,
surgery Aged Carcinoma, Squamous Cell / mortality, surgery Esophageal Neoplasms / mortality, surgery* Esophagectomy / methods Female Humans Length of Stay Male Middle Aged Postoperative Complications Retrospective Studies Risk Factors Survival Rate |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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