HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Goldfaden, D. Articles by Kalish, R. Search for Related Content PubMed PubMed Citation Articles by Goldfaden, D. Articles by Kalish, R.

The Journal of Thoracic and Cardiovascular Surgery, Vol 91, 242-247, Copyright © 1986 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Adenocarcinoma of the distal esophagus and gastric cardia. Comparison of results of transhiatal esophagectomy and thoracoabdominal esophagogastrectomy

D Goldfaden, MB Orringer, HD Appelman and R Kalish

Between 1965 and 1984, 72 patients underwent operation for adenocarcinoma of the distal esophagus or gastric cardia. A standard transthoracic esophagogastrectomy and esophagogastrostomy was performed in 43 and a transhiatal esophagectomy without thoracotomy and partial proximal gastrectomy was performed in 29. There was no significant difference between the two groups in age, sex, or TNM tumor staging. The perioperative complication rate was 86% in the esophagogastrectomy patients and 48% in the transhiatal esophagectomy patients (p less than 0.05). Mortality was higher in the esophagogastrectomy group (14%) than in the transhiatal esophagectomy group (7%). Average operative blood loss was greater in the esophagogastrectomy patients (2,510 versus 1,187 ml). Average postoperative hospitalization was longer for the esophagogastrectomy patients (22.2 days versus 12.3 days). Both differences are statistically significant (p less than 0.05). Late results, as evaluated by life-table analysis, showed no significant difference in survival between the two groups of patients. Because the morbidity and mortality rates of transhiatal esophagectomy are as low as or lower than those for esophagogastrectomy, late survival is as good, and palliation is superior (less suture-line tumor recurrence and reflux esophagitis), we believe that transhiatal esophagectomy is the preferred operative approach in patients with adenocarcinoma of the distal esophagus or gastric cardia.

This article has been cited by other articles:

				J. A. Hagen and T. R. DeMeester Esophageal adenocarcinoma Ann. Thorac. Surg., October 1, 2001; 72(4): 1430 - 1432. [Full Text] [PDF]

				A. L. Visbal, M. S. Allen, D. L. Miller, C. Deschamps, V. F. Trastek, and P. C. Pairolero Ivor Lewis esophagogastrectomy for esophageal cancer Ann. Thorac. Surg., June 1, 2001; 71(6): 1803 - 1808. [Abstract] [Full Text] [PDF]

				N. M. Gupta and N. M. Gupta Transhiatal Versus Transthoracic Esophagectomy for Distal Esophageal Cancer Asian Cardiovasc Thorac Ann, December 1, 2000; 8(4): 347 - 352. [Abstract] [Full Text] [PDF]

				N. T. Nguyen, D. M. Follette, B. M. Wolfe, P. D. Schneider, P. Roberts, and J. E. Goodnight Jr Comparison of Minimally Invasive Esophagectomy With Transthoracic and Transhiatal Esophagectomy Arch Surg, August 1, 2000; 135(8): 920 - 925. [Abstract] [Full Text] [PDF]