Journal article
Vagal-sparing esophagectomy - The ideal operation for intramucosal adenocarcinoma and Barrett with high-grade dysplasid
Annals of surgery, v 246(4), pp 665-674
01 Oct 2007
PMID: 17893503
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Objective: Our aim was to compare outcome of vagal-sparing esophagectomy with transhiatal and en bloc esophagectomy in patients with intramucosal adenocarcinoma or high-grade dysplasia.
Summary Background Data: lntramucosal adenocarcinoma and high grade dysplasia have a low likelihood of lymphatic or systemic metastases and esophagectomy is curative in most patients. However, traditional esophagectomy is associated with significant morbidity and altered gastrointestinal function. A vagal-sparing esophagectomy offers the advantages of complete disease removal with the potential for reduced morbidity and a better functional outcome.
Method: Retrospective review of outcome in patients with intramucosal adenocarcinoma or high grade dysplasia that had a vagal-sparing (n = 49), transhiatal (n = 39) or en bloc (n = 21) esophagectomy.
Results: The length of hospital stay and the incidence of major complications was significantly reduced with a vagal-sparing esophagectomy compared with a transhiatal or en bloc resection. Further, postvagotomy dumping and diarrhea symptoms were significantly less common, and weight was better maintained postoperatively with a vagal-sparing esophagectomy. Recurrent cancer has developed in only 1 patient.
Conclusion: Survival with intramucosal adenocarcinoma or Barrett's with high-grade dysplasia is independent of the type of resection. A vagal-sparing esophagectomy is associated with significantly less perioperative morbidity and a shorter hospital stay than a transhiatal or en bloc esophagectomy. Further, late morbidity including weight loss, dumping, and diarrhea are significantly less likely after a vagal-sparing approach. Consequently a vagal-sparing esophagectomy is the preferred procedure for patients with intramucosal adenocarcinoma or high grade dysplasia.
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Details
- Title
- Vagal-sparing esophagectomy - The ideal operation for intramucosal adenocarcinoma and Barrett with high-grade dysplasid
- Creators
- Christian G. Peyre - University of Southern CaliforniaSteven R. DeMeester - Southern California University for Professional StudiesChristian Rizzetto - Southern California University for Professional StudiesNeeraj Bansal - University of Southern CaliforniaAndrew L. Tang - University of Southern CaliforniaShahin Ayazi - Southern California University for Professional StudiesJessica M. Leers - University of Southern CaliforniaJohn C. Lipham - Southern California University for Professional StudiesJeffrey A. Hagen - Southern California University for Professional StudiesTom R. DeMeester - Southern California University for Professional Studies
- Publication Details
- Annals of surgery, v 246(4), pp 665-674
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 10
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:000249753500018
- Scopus ID
- 2-s2.0-34748897150
- Other Identifier
- 991022048376704721
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- Surgery