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Transhiatal and transthoracic esophagectomy: A comparative study
Author(s) -
Bolton John S.,
Sardi Armando,
Bowen John C.,
Ellis James K.
Publication year - 1992
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.2930510410
Subject(s) - medicine , american society of anesthesiologists , intensive care unit , esophagectomy , surgery , stage (stratigraphy) , mortality rate , esophageal cancer , cancer , paleontology , biology
From January 1981 to December 1990, 55 consecutive patients underwent esophageal resection by either the transhiatal (THE, 26 patients) or transthoracic (TTE, 29 patients) approach. Patient age, tumor size, and tumor stage were similar in the two groups. THE patients had a significantly worse mean preoperative American Society of Anesthesiologists (ASA) risk class assigned by the anesthesiologist. Patients who underwent THE had a significantly lower operative mortality and rate of cardiopulmonary complications, significantly shorter intensive care unit and hospital length of stay, and a significantly better postoperative survival when operative deaths are included in the analysis. Operative deaths in the TTE group were concentrated among patients > 65 years of age (4 of 9 died), in an ASA risk class ⩾III (3 of 7 died) or with moderate or severe cardiac or pulmonary impairment preoperatively (4 of 6 died). © 1992 Wiley‐Liss, Inc.