Document Detail

Transthoracic versus transhiatal esophagectomy for distal esophageal cancer: which is superior?
MedLine Citation:
PMID:  21051381     Owner:  NLM     Status:  In-Data-Review    
A best evidence topic in cardiothoracic surgery was written according to a structured protocol. The question addressed was whether transthoracic esophagectomy (TTE) or transhiatal esophagectomy (THE) resection provides superior outcomes for patients with distal esophageal cancer. Two hundred and sixteen papers were found using the reported search, of which six represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. We conclude that THE is associated with significantly less pulmonary complications as well as fewer wound infections, chylous leakage but a higher rate of cardiac complications, vocal cord paralysis and anastomotic leakage as compared with TTE. Overall, THE is associated with a reduced perioperative morbidity as evidenced by with a shorter hospital stay and decreased in-hospital mortality rates. With regard to long-term outcomes, although there is no evidence that TTE or THE result in different overall long-term survival rates, there is some evidence that TTE offers superior five-year survival rate in a sub-group of patients with a limited number of involved lymph nodes.
Hugh Colvin; Joel Dunning; Omar A Khan
Publication Detail:
Type:  Journal Article     Date:  2010-11-03
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  12     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  265-9     Citation Subset:  IM    
Department of Cardiothoracic Surgery, Freeman Hospital, Newcastle, UK.
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