Transhiatal Esophagectomy for Palliative Treatment of Advanced Esophageal Carcinoma

Authors

  • Puttisak Puttawibul Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hadyai, Songkhla, Thailand 90112.
  • Apinop Chanvitan Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hadyai, Songkhla, Thailand 90112.
  • Chuchart Pornpattanarak Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hadyai, Songkhla, Thailand 90112.
  • Burapat Sangthong Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hadyai, Songkhla, Thailand 90112.

Keywords:

Transhiatal esophagectomy, esophageal carcinoma

Abstract

The decision for palliation or curative treatment of esophageal carcinoma is based on the staging of the tumor and the patient's nutritional status. Poor status patients in the advanced stage may not tolerate the radical en block dissection. Transhiatal Esophagectomy (THE) has been advocated for palliation due to a lower respiratory complication rate as opposed to tumor resection via thoracotomy. This article reviews the results of THE in advanced esophageal cancer patients in Songklanagarind Hospital.

Materials and Methods: Esophageal carcinoma patients who underwent THE were studied, and the tumor characteristics, tumor staging and the results of operation were analyzed. The overall outcomes of the palliative surgery were reported.

Results: From August 1985 to February 1997, fifty seven esophageal carcinoma patients were operated by THE at Songklanagarind Hospital. The average ages were 63.77 years in male patients and 69.36 years in female patients. The tumors were 1 case (1.75 %) , 8 cases (14.04 %), 25 cases (43.86 %), 21 cases (36.84 %), and 2 cases (3..51 % ) in cervical, upper thoracic, mid thoracic, lower thoracic and esophagogastric respectively.

The average time for operation was 227. 11 ± 48.73 minutes. Intraoperative blood loss was 500 ± 317.52 ml. Operative death occurred in 6 cases, and hospital death occurred in 2 cases. Massive postoperative bleeding led to death occurred in one case. Pneumonia and respiratory failure were the causes of death in 2 cases. The incidence of anastomotic leakage was 5 cases (8.77 %). Stricture of the anastomosis was detected in 7 cases (12.25 %). There was no tracheal lacerations during dissection. The average postoperative hospital stay was 24.75 days.

Conclusion: The overall results, morbidity and mortality for palliative treatment of esophageal carcinoma by THE were presented. Respiratory tract complications and stricture of anastomosis were the common complications. There was no evidence of vital organ injuries during operative dissection, but there was one case of postoperative massive bleeding resulting in death. THE can be an alternative simple procedure for palliation of advanced esophageal carcinoma.

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Published

2000-03-31

How to Cite

1.
Puttawibul P, Chanvitan A, Pornpattanarak C, Sangthong B. Transhiatal Esophagectomy for Palliative Treatment of Advanced Esophageal Carcinoma. Thai J Surg [Internet]. 2000 Mar. 31 [cited 2024 Apr. 29];21(1):23-8. Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/243361

Issue

Vol. 21 No. 1 (2000): January - March

Section

Original Articles

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Articles must be contributed solely to The Thai Journal of Surgery and when published become the property of the Royal College of Surgeons of Thailand. The Royal College of Surgeons of Thailand reserves copyright on all published materials and such materials may not be reproduced in any form without the written permission.