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Outcomes of Esophagectomy for Esophageal Achalasia in the United States

  • 2013 SSAT Poster Presentation
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

While the outcomes after Heller myotomy have been extensively reported, little is known about patients with esophageal achalasia who are treated with esophagectomy.

Methods

This was a retrospective analysis using the Nationwide Inpatient Sample over an 11-year period (2000–2010). Patients admitted with a primary diagnosis of achalasia who underwent esophagectomy (group 1) were compared to patients with esophageal cancer who underwent esophagectomy (group 2) during the same time period. Primary outcome was in-hospital mortality. Secondary outcomes included length of stay, postoperative complications, and total hospital charges. A propensity-matched analysis was conducted comparing the same outcomes between group 1 and well-matched controls in group 2.

Results

Nine hundred sixty-three patients with achalasia and 18,003 patients with esophageal cancer underwent esophagectomy. The propensity matched analysis showed a trend toward a higher mortality in group 2 (7.8 vs. 2.9 %, p = 0.08). Postoperative length of stay and complications were similar in both groups. Total hospital charges were higher for the achalasia group ($115,087 vs. $99, 654.2, p = 0.006).

Conclusion

This is the largest study to date examining outcomes after esophagectomy in patients with achalasia. Based on our findings, esophagectomy can be considered a safe option, and surgeons should not be hindered by a perceived notion of prohibitive operative risk in this patient population.

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Conflicts of Interest

None

Source of Financial Support

Mr. Edwin Lewis provided generous support of Dr. Lidor’s Department of Surgery Research Fund.

Meeting Presentation

Presentation as a SSAT Poster of Distinction during the 54th DDW Annual Meeting at the Orange County Convention Center in Orlando, Florida, May 18–21, 2013.

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Authors and Affiliations

  1. Division of Thoracic Surgery, Department of Surgery, Johns Hopkins University, 600 N Wolfe Street, Blalock 240, Baltimore, MD, 21287, USA

    Daniela Molena & Benedetto Mungo

  2. Department of Surgery, Johns Hopkins University, 600 N Wolfe Street, Baltimore, MD, 21287, USA

    Miloslawa Stem, Richard L. Feinberg & Anne O. Lidor

Authors
  1. Daniela Molena
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  2. Benedetto Mungo
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  3. Miloslawa Stem
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  4. Richard L. Feinberg
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  5. Anne O. Lidor
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Corresponding author

Correspondence to Daniela Molena.

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Molena, D., Mungo, B., Stem, M. et al. Outcomes of Esophagectomy for Esophageal Achalasia in the United States. J Gastrointest Surg 18, 310–317 (2014). https://doi.org/10.1007/s11605-013-2318-y

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  • DOI: https://doi.org/10.1007/s11605-013-2318-y

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