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Clinical significance of mediastinoscope-assisted transhiatal esophagectomy in patients with esophageal cancer

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Abstract

Purpose

Mediastinoscope-assisted transhiatal esophagectomy (MATHE) is a useful surgical procedure in esophageal cancer patients who have limited indications for transthoracic operations due to preoperative complications.

Methods

In the last 10 years, 63 patients underwent MATHE at our department. We examined the clinical data of these patients and assessed the indications, postoperative outcomes, and prognostic factors of MATHE.

Results

The 5-year overall survival (OS) rate was 53.4 %, and disease-free survival (DFS) rate was 66.0 %. Postoperative complications were observed in 22 cases (34.9 %), and recurrent disease occurred in 17 cases (27.0 %). On univariate analyses of OS, location of the tumor, tumor depth, lymph node metastasis, clinical stage, simultaneous resection of other organs, postoperative pneumonia, and blood loss were significant prognostic factors. On multivariate analyses, location of the tumor and lymph node metastasis were independent prognostic factors of OS. On univariate analyses, location of the tumor, tumor depth, lymph node metastasis, clinical stage, and blood loss were significant prognostic factors of DFS, while on multivariate analyses of DFS, lymph node metastasis and blood loss were independent prognostic factors.

Conclusion

MATHE is a useful procedure for the middle to lower thoracic esophageal cancer patients without clinical lymph node metastasis with serious complications who were unable to undergo thoracotomy.

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Conflicts of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Authors’ contributions

Study conception and design: Hiroshi Okumura and Shoji Natsugoe; acquisition of data: Hiroshi Okumura, Yasuto Uchikado, Masataka Matsumoto, Itaru Omoto, Ken Sasaki, Yoshiaki Kita, Takaaki Arigami, Yoshikazu Uenosono, Akihiro Nakajo, Tetsuhiro Owaki, and Shoji Natsugoe; analysis and interpretation of data: Hiroshi Okumura, Yasuto Uchikado, Masataka Matsumoto, and Shoji Natsugoe; drafting of manuscript: Hiroshi Okumura; and critical revision of manuscript: Shinichiro Mori, Sumiya Ishigami, and Shoji Natsugoe

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Authors and Affiliations

  1. Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical Sciences, Kagoshima University, Sakuragaoka 8-35-1, Kagoshima, 890-8520, Japan

    Hiroshi Okumura, Yasuto Uchikado, Masataka Matsumoto, Itaru Omoto, Ken Sasaki, Yoshiaki Kita, Takaaki Arigami, Yoshikazu Uenosono, Akihiro Nakajo, Tetsuhiro Owaki, Shinichiro Mori, Sumiya Ishigami & Shoji Natsugoe

Authors
  1. Hiroshi Okumura
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  2. Yasuto Uchikado
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  3. Masataka Matsumoto
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  4. Itaru Omoto
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  5. Ken Sasaki
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  6. Yoshiaki Kita
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  7. Takaaki Arigami
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  8. Yoshikazu Uenosono
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  9. Akihiro Nakajo
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  10. Tetsuhiro Owaki
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  11. Shinichiro Mori
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  12. Sumiya Ishigami
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  13. Shoji Natsugoe
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Corresponding author

Correspondence to Hiroshi Okumura.

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Okumura, H., Uchikado, Y., Matsumoto, M. et al. Clinical significance of mediastinoscope-assisted transhiatal esophagectomy in patients with esophageal cancer. Langenbecks Arch Surg 400, 699–706 (2015). https://doi.org/10.1007/s00423-015-1330-y

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  • DOI: https://doi.org/10.1007/s00423-015-1330-y

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