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Experience With 160 Cases

Gary A. J. Gelfand, MD; Richard J. Finley, MD; Bill Nelems, MD; Richard Inculet, MD; Kenneth G. Evans, MD; Guy Fradet, MD

Arch Surg. 1992;127(10):1164-1168.

Abstract
• We reviewed our experience from 1979 to 1990 with 160 cases of transhiatal esophagectomy for carcinoma of the lower esophagus and cardia to evaluate trends in patient selection, management, and outcome. Patients treated in the past 6 years (n=110) and those treated before 1985 (n=50) were similar in terms of age and sex distribution, medical history, and weight loss. The majority of tumors seen were adenocarcinoma, with patients in the latter group having significantly lower stages. Significant decreases in anesthetic time, units of blood transfusions, chest tube insertions, length of postoperative ventilation, incidence of postoperative pneumonia, and length of hospital stay were seen during the past 6 years. Wound infections increased significantly during the same period. The decrease in the 30-day mortality rate from 6% to 0.9% was not significant. Survival rates did not differ between groups, with overall rates of 62%, 40%, and 21% at 1, 2, and 5 years, respectively.

(Arch Surg. 1992;127:1164-1168)

Author Affiliations
From the Departments of Surgery, University of British Columbia, Vancouver (Drs Gelfand, Finley, Nelems, Evans, and Fradet), and University of Western Ontario, London (Dr Inculet).

Footnotes
Accepted for publication June 21, 1992.

Presented at the 63rd Annual Meeting of the Pacific Coast Surgical Association, Kauai, Hawaii, February 17, 1992.

Reprints not available.

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