eISSN: 1897-4317
ISSN: 1895-5770
Gastroenterology Review/Przegląd Gastroenterologiczny
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2/2017
vol. 12
 
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abstract:
Original paper

Transthoracic versus transhiatal esophagectomy – influence on patient survival

Mariusz Łochowski
,
Barbara Łochowska
,
Józef Kozak

Gastroenterology Rev 2017; 12 (2): 118–121
Online publish date: 2016/12/16
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Aim: To evaluate the survival of patients after surgery of the esophagus/cardia using the transthoracic and transhiatal methods.

Material and methods: In the years 2007–2011, 102 patients were radically treated for cancer of the esophagus/cardia: 24 women and 78 men at the average age of 59.5. There were 38 transthoracic procedures and 64 transhiatal procedures. All patients had a conduit made from the stomach, led through lodges in the esophagus and combined with the stump of the esophagus in the neck following the Collard method. Two-pole lymphadenectomies were performed in all patients.

Results: Patients after transthoracic procedures had statistically more (p < 0.05) lymph nodes removed than patients after transhiatal procedures. The 5-year survival rates in transhiatal and transthoracic procedures did not statistically differ, being 8% and 0% respectively. The length of patient survival was influenced by metastases in the nearby lymph nodes (p < 0.0001) and the presence of adenocarcinoma.

Conclusions: Surgical access (transhiatal and transthoracic surgery) does not affect the 5-year survival rates. Transhiatal surgery allows a greater number of lymph nodes to be removed. The main factor influencing the 5-year survival rate is the presence of metastases in the nearby lymph nodes.
keywords:

cancer of esophagus, transthoracic surgery, transhiatal surgery, survival length

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