Abstract
During the period between 1979 and 1988, 145 patients with cancer of the esophagus were admitted to our department. They were examined for the preoperative risk factors associated with multiple organ function and classified into three groups according to the risk score. Special attention was paid to postoperative pulmonary complications, mortality and the long term results of surgery in the poor-risk patients and the findings analyzed in reference to the operative procedures. The resection rate for the poor-risk group was 41 per cent, however, esophagectomy was only able to be combined with a right thoracotomy and abdominal approach in 26 per cent of the patients in this group. Postoperative pulmonary complications developed in 64 per cent of the poor-risk patients who underwent a transthoracic esophagectomy and in only 25 per cent of those who received a transhiatal esophagectomy, although there was no significant difference in the overall survival rate beteeen these two subgroups. The present observations therefore raised the possibility that transhiatal esophagectomy may improve the results of surgical treatment for poor-risk patients with esophageal cancer.
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Nishi M, Hiramatsu Y, Hioki K, Hatano T, Yamamoto M. Pulmonary complications after subtotal oesophagectomy. Br J Surg 1988; 75: 527–530.
Launois B, Paul JL, Lygidakis NJ, Campion JP, Malledant Y, Grossetti D, Delarue D. Results of the surgical treatment of carcinoma of the esophagus. Surg Gynecol Obstet 1985; 156: 753–760.
Sugimachi K, Inokuchi K, Ueo H, Matsuura H, Matsuzaki K, Mori M. Surgical treatment for carcinoma the esophagus in the elderly patient. Surg Gynecol Obstet 1985; 160: 317–319.
Japanese Committee for Registration of Esophageal Carcinoma. A proposal for a new TNM classification of esophageal carcinoma. Jpn J Clin Oncol 1985; 15: 625–636.
Postlethwait RW. Complications and deaths after operations for esophageal carcinoma. J Thorac Cardiovasc Surg 1983; 85: 827–831.
Yamanaka H, Nishi M, Kanemaki T, Hosoda N, Hioki K, Yamamoto M. Preoperative nutritional assessment to predict postoperative complication in gastric cancer patients. J Par Ent Nutr 1989; 13: 286–291.
Lewin I, Lerner AG, Green SH, Del Guercio LRM, Siegel JH. Physical class and physiologic status in the prediction of operative mortality in the aged sick. Ann Surg 1971; 174: 217–231.
Orringer MB. Palliative procedures for esophageal cancer. Surg Clin North Am 1983; 63: 941–950.
Akiyama H, Tsurumaru M, Kawamura T, Ono Y. Principles of surgical treatment for carcinoma of the esophagus. Ann Surg 1981; 194: 438–445.
Murakami T. Studies on postoperative pulmonary complications after surgery for esophageal cancer: Especially the relationship between the vagus nerve and pulmonary complication. Arch Jap Chir 1978; 47: 413–426.
Garvin PJ, Kaminski DL. Extrathoracic esophagectomy in the treatment of esophageal cancer. Am J Surg 1980; 140: 772–778.
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Yamanaka, H., Hiramatsu, Y., Kawaguchi, Y. et al. Surgical treatment for poor-risk patients with carcinoma of the esophagus. The Japanese Journal of Surgery 21, 178–183 (1991). https://doi.org/10.1007/BF02470906
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DOI: https://doi.org/10.1007/BF02470906