Document Detail


Surgical management of esophageal cancer. A decade of change.
MedLine Citation:
PMID:  8185398     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
J S Bolton; J L Ochsner; A A Abdoh
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of surgery     Volume:  219     ISSN:  0003-4932     ISO Abbreviation:  Ann. Surg.     Publication Date:  1994 May 
Date Detail:
Created Date:  1994-06-14     Completed Date:  1994-06-14     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0372354     Medline TA:  Ann Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  475-80     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Ochsner Medical Institutions, Jefferson, Louisiana.
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MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma / 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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