Annals of Surgical Oncology

, Volume 13, Issue 4, pp 557–564 | Cite as

The Influence of Technical Complications on Postoperative Outcome and Survival After Esophagectomy

  • Lorenzo E. Ferri
  • Simon Law
  • Kam-Ho Wong
  • Ka-Fai Kwok
  • John Wong
Article

Abstract

Background

The dismal survival associated with esophagectomy for cancer has led to the search for potentially correctable factors responsible for this poor prognosis. Although it is intuitive that technical complications could increase postoperative mortality, the effect on long-term survival is controversial.

Methods

From 1990 to 2002, 434 patients underwent resection for squamous cell carcinoma of the intrathoracic esophagus. Prospectively collected data were reviewed for the presence of technical complications. Patient, tumor, and operative variables, postoperative outcome, and survival were compared between patients with technical complications and those without. Prognostic factors were assessed by multivariate analysis.

Results

Technical complications occurred in 98 (22.6%) patients. Patients with technical complications had a higher prevalence of cardiac disease, more proximal tumors, and more cervical anastomoses. Technical complications were associated with an increased rate of pulmonary complications (37.8% vs. 10.7%; P < .001) and increased hospital mortality (9.2% vs. 3.3%; P = .025), but no difference in 30-day mortality (2% vs. 1.2%; P = .6). Poor-prognostic factors for survival included male sex, stage III/IV disease, cirrhosis, proximal tumors, and R1/R2 resection, but not technical complications.

Conclusions

Although immediate postoperative outcome and hospital mortality rates were increased, no effect on long-term survival was seen in patients with complications related to errors in surgical technique.

Keywords

Esophageal cancer Survival Complications Mortality 

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Copyright information

© The Society of Surgical Oncology, Inc. 2006

Authors and Affiliations

  • Lorenzo E. Ferri
    • 1
  • Simon Law
    • 1
  • Kam-Ho Wong
    • 1
  • Ka-Fai Kwok
    • 1
  • John Wong
    • 1
  1. 1.Department of Surgery, Division of Esophageal SurgeryUniversity of Hong Kong Medical Centre, Queen Mary HospitalChina

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