Comparing Outcomes after Transthoracic and Transhiatal Esophagectomy: A 5-Year Prospective Cohort of 17,395 Patients

Connors, Rafe C.; Reuben, Brian; Neumayer, Leigh; Bull, David A.

doi:10.1016/j.jamcollsurg.2007.07.001

Cited by 132 publications

(89 citation statements)

References 25 publications

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“…Finally, there were significantly fewer serious complications (grades [3][4][5] in the MIE group (19% vs. 48%, p=0.0008).…”

Section: Resultsmentioning

confidence: 85%

“…Esophageal cancer is the eighth most common cause of cancer worldwide 3 . In 2010, it is estimated that there will be 16,640 new cases diagnosed in the U.S. and 14,500 deaths 1 .…”

Section: Introductionmentioning

confidence: 99%

“…Mortality rates range from 5-20% 2,3 and morbidity generally occurs in approximately 50% of patients 3 . Many series also report higher rates of complications with transthoracic esophagectomy compared to transhiatal esophagectomy 4 .…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Oncologic Efficacy Is Not Compromised, and May Be Improved with Minimally Invasive Esophagectomy

Berger¹,

Bloomenthal²,

Weksler³

et al. 2011

Journal of the American College of Surgeons

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“…Finally, there were significantly fewer serious complications (grades [3][4][5] in the MIE group (19% vs. 48%, p=0.0008).…”

Section: Resultsmentioning

confidence: 85%

“…Esophageal cancer is the eighth most common cause of cancer worldwide 3 . In 2010, it is estimated that there will be 16,640 new cases diagnosed in the U.S. and 14,500 deaths 1 .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Oncologic Efficacy Is Not Compromised, and May Be Improved with Minimally Invasive Esophagectomy

Berger¹,

Bloomenthal²,

Weksler³

et al. 2011

Journal of the American College of Surgeons

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“…Moreover the authors warned that these results should be analyzed with caution as more advanced tumors might have been treated preferentially with TTE which could have compromised the potential survival benefit. Indeed, a large volume, multicentric study dealing with more than 17,000 patients failed to confirm the advantage of THE in short term outcomes (17).…”

Section: Diversity Of Approachesmentioning

confidence: 99%

Principles of esophageal cancer surgery, including surgical approaches and optimal node dissection (2- vs. 3-field)

Nafteux¹,

Depypere²,

Veer³

et al. 2017

Ann. Cardiothorac. Surg.

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Surgery for esophageal carcinoma and carcinoma of the gastro-esophageal junction (GEJ) is considered as one of the most complex and challenging interventions on the digestive tract. This is due to the intimate relations with vital structures in the chest and the tendency of early lymphatic dissemination via a dense and complex submucosal network. This review article discusses the different aspects of surgical access routes in the light of the ever-evolving techniques, in particular the minimally invasive esophagectomy (MIE). The aspects of surgical approach are inextricably linked to the still ongoing debate on extent of lymphadenectomy, a debate that is obtaining a new dimension in view of the widely applied neoadjuvant therapy protocols as well as in view of the increasing importance of quality of life aspects after surgery. Finally, the authors provide a practical and patient tailored approach as applied in their center.

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“…In a meta-analysis comparing THE and transthoracic esophagectomy (TTE), Hulscher et al (7) concluded that there was no difference between the two types of resection in terms of 3-and 5-year survival rates. Another large-volume multicenter study that compared outcomes following TTE and THE found the two to be equivalent, although higher-volume centers had lower morbidity and mortality rates (8). Nonetheless, open esophagectomy has the highest mortality and morbidity rate within the field of elective gastrointestinal surgery (9).…”

Section: Introductionmentioning

confidence: 99%

Changing trends and experience with esophageal cancer surgery in a single university hospital: are the results similar or not?

Çelik¹,

Doğan²,

Arslan³

et al. 2017

Bagcilar Medical Bulletin

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Objective:The main treatment modality for esophageal cancer remains to be surgery. Over the last decades, surgical strategies have evolved remarkably. When neoadjuvant chemoradiotherapy became standard, discussions about the role, type, and timing of surgery began. In this study, we share results we obtained after operating our patients using various surgical techniques. Material and Methods: Reliable data from 51 esophageal cancer patients were evaluated retrospectively. Of the 51 cases, 31 were operable. These operable cases were further classified according to surgical method and neoadjuvant therapy status. Median survival time in months, complications, hospital mortality, length of hospital stay, and pathology results (total lymph nodes harvested and pathologic tumor node metastasis stage [p_TNM]) were documented for the different surgical approaches. Results: Open surgical methods were performed in 21 cases, while in 10 cases the Minimally Invasive Surgery (MIS) method was used. The MIS group received neoadjuvant therapy more frequently than the open surgical methods group (p=0.013). Although more complications were observed in the MIS group, the difference to the open esophagectomy methods group was not significant. Patients in the MIS group also had longer hospital stays, but again the difference was not significant. Although a pathologic complete response was seen in 8 of the 11 (72.7%) patients in our study who received chemoradiotherapy as neoadjuvant treatment, the surgical results of patients who received chemoradiotherapy were worse, although not to a statistically significant extent. Conclusion: Despite changing trends and treatment options in esophageal cancer surgery, we have yet to see the expected improved results. Keywords: esophagus cancer, minimally invasive surgery, neoadjuvant therapy ÖZETÖzofagus kanser cerrahisinde tek üniversite hastanesi deneyimleri ve değişen trendler; sonuçlar değişti mi?Amaç: Özofagus kanserinin temel tedavi yöntemi cerrahi olarak devam etmektedir. Son dekatlarda cerrahi yöntemlerde ciddi ilerlemeler olmuştur. Neoadjuvan kemoradioterapinin stantdart hale gelmesi ile beraber, cerrahinin tedavideki yeri, cerrahi yöntemin tipi ve zamanlaması tartışılmaya başlanmıştır. Bu çalış-mada, farklı cerrahi yöntemler ile tedavi edilen vakalarımızın sonuçları paylaşıldı. Yöntem: Özofagus kanserli 51 vakanın verileri retrospektif olarak değerlendirildi. Bu 51 vakanın 31 tanesi operable idi. Ameliyat edilen 31 vaka, ayrıca cerrahi yönteme ve neoadjuvant kemoradioterapiye göre alt gruplara ayrıldı. Ay olarak median sağ-kalım süreleri, komplikasyonlar, hastane mortaliteleri, yatış süreleri ve patoloji sonuçları (toplam çıkarılan lenf nodu sayısı, TNM sınıflaması) farklı cerrahi tekniklere göre yorumlandı. Bulgular: Açık cerrahi teknikler ile 21 vaka ameliyat edilirken, 10 vaka minimal invazif yöntemler (MİY) ile ameliyat edildi. Açık cerrahi yöntemlere göre MİY ile ameliyat olanlar daha sıklıkla neoadjuvant tedavi almış idi (p=0.013). MİY ile ameliyat olan grupta daha fazla ...

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Comparing Outcomes after Transthoracic and Transhiatal Esophagectomy: A 5-Year Prospective Cohort of 17,395 Patients

Cited by 132 publications

References 25 publications

Oncologic Efficacy Is Not Compromised, and May Be Improved with Minimally Invasive Esophagectomy

Oncologic Efficacy Is Not Compromised, and May Be Improved with Minimally Invasive Esophagectomy

Principles of esophageal cancer surgery, including surgical approaches and optimal node dissection (2- vs. 3-field)

Changing trends and experience with esophageal cancer surgery in a single university hospital: are the results similar or not?

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