Journal article
Transthoracic versus transhiatal esophagectomy: A prospective study of 945 patients
The Journal of thoracic and cardiovascular surgery, v 125(5), pp 1114-1120
May 2003
PMID: 12771885
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Objective: Debate continues as to whether transhiatal esophagectomy results in lower morbidity and mortality than transthoracic esophagectomy. Most data addressing this issue are derived from single-institution studies. To investigate this question from a nationwide multicenter perspective, we used the Veterans Administration National Surgical Quality Improvement Program to prospectively analyze risk factors for morbidity and mortality in patients undergoing transthoracic esophagectomy or transhiatal esophagectomy from 1991 to 2000. Methods: Univariate and multivariate analyses were performed on 945 patients (mean age, 63 ± 10 years). There were 562 transthoracic esophagectomies and 383 transhiatal esophagectomies in 105 hospitals, with complete 30-day outcomes recorded. Results: There were no differences in recorded preoperative variables between the groups that might bias any comparisons. Overall mortality was 10.0% (56/562) for transthoracic esophagectomy and 9.9% (38/383) for transhiatal esophagectomy (P = .983). Morbidity occurred in 47% (266/562) of patients after transthoracic esophagectomy and in 49% (188/383) of patients after transhiatal esophagectomy (P = .596). Risk factors for mortality common to both groups included a serum albumin value of less than 3.5 g/dL, age greater than 65 years, and blood transfusion of greater than 4 units (P < .05). When comparing transthoracic esophagectomy with transhiatal esophagectomy, there was no difference in the incidence of respiratory failure, renal failure, bleeding, infection, sepsis, anastomotic complications, or mediastinitis. Wound dehiscence occurred in 5% (18/383) of patients undergoing transhiatal esophagectomy and only 2% (12/562) of patients undergoing transthoracic esophagectomy (P = .036). Conclusions: These data demonstrate no significant differences in preoperative variables and postoperative mortality or morbidity between transthoracic esophagectomy and transhiatal esophagectomy on the basis of a 10-year, prospective, multi-institutional, nationwide study.
J Thorac Cardiovasc Surg 2003;125:1114-20
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Details
- Title
- Transthoracic versus transhiatal esophagectomy: A prospective study of 945 patients
- Creators
- Jeffrey Rentz - University of UtahDavid Bull - University of UtahDavid Harpole - Duke UniversityStephen Bailey - University of UtahLeigh Neumayer - University of UtahTheodore Pappas - Duke UniversityBarbara Krasnicka - Mass General BrighamWilliam Henderson - Harvard UniversityJennifer Daley - Signature Healthcare Brockton HospitalShukri Khuri - The Coordinating Center
- Publication Details
- The Journal of thoracic and cardiovascular surgery, v 125(5), pp 1114-1120
- Publisher
- Elsevier
- Number of pages
- 7
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Cardiothoracic Surgery
- Web of Science ID
- WOS:000183266600020
- Scopus ID
- 2-s2.0-0038350966
- Other Identifier
- 991021960810704721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems
- Respiratory System
- Surgery