Clinical Results of Transhiatal Esophagectomy for Carcinoma of the Lower Esophagus
Thirty three cases with the lower esophageal cancer were submitted to transhiatal esophagectomy. In this procedure, the tumor and lymph node around the middle or lower esophagus could be dissected safely under the direct vision. And, the whole stomach was brought up to the neck through the posterior mediastinal route. As for postoperative complications, Pneumothorax occurred in 8 cases (24%), hoarseness in 4 cases (12%), pneumonia in 3 cases (9%), pyothorax and hemothorax in 2 cases (3%) each. Two cases died within 30 days of operation due to massive bleeding during operation and mediastinitis. Five year survival rate of 31 cases except for 2 cases of postoperative death was 24.8%. First recurrent sites were investigated for 16 cases who recurred. Nine cases recurred to parenchymatous organs, 4 cases to lymph nodes, 2 cases as a dissemination and 1 case to the remnant esophagus. From these results, we concluded that the intensive chemotherapy before or after the operation should be performed rather than extended lymph node dissection of the upper mediastinal area through thoracolaparotomy for the lower esophageal cancer.
Key WordsEsophageal cancer Transhiatal esophagectomy Survival rate
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