Complications following Video-Assisted Transhiatal Esophagectomy for Esophageal Cancer

Publisher： Karger

E-ISSN： 2297-475x|21|1|68-73

ISSN： 2297-4725

Source： Visceral Medicine (formerly: Viszeralmedizin), Vol.21, Iss.1, 2005-03, pp. : 68-73

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Abstract

Background: The aim of the study was to evaluate theclinical safety and usefulness of esophageal dissectionunder laparoscopic monitoring during transhiatal esophagectomyfor esophageal cancer. Patients and Methods:The study group of 115 patients included 102 menand 13 women. The mean age was 57 (range 32-79)years. Tumor histology showed a squamous cell carcinomain 75% and an adenocarcinoma in 25% of cases. Accordingto the American Joint Committee on Cancerclassification, 3 patients were classified as stage I, 19 asstage IIA, 24 as stage IIB, 64 as stage III, and 5 as stageIVA. Mean operating time was 4.5 ± 1 h. Results: Tensignificant intraoperative complications were observed(9 hemorrhages, 1 death). The mean blood loss was 900(range 300-2,100) ml. Postoperative complications occurredin 61% of the patients; the most frequent werepulmonary complications (27%), recurrent laryngealnerve injury (17.4%), anastomotic stricture (14%), andanastomotic leak (10.4%). Early re-laparotomy was performedin 6% of the patients. Hospital mortality rate was9%. Mean hospital stay was 34 (range 5-64) days. Conclusion:Video-assisted transhiatal esophagectomy is auseful method, but does not allow a vision-guided removalof the upper esophagus. The method does notprevent or diminish the number of intra- and postoperativecomplications of esophageal resection.