COMPARISON OF THE RESULTS OF ESOPHAGECTOMY WITH AND WITHOUT A THORACOTOMY

  • 1 January 1981
    • journal article
    • research article
    • Vol. 153  (5) , 653-656
Abstract
Two techniques of esophagectomy for carcinoma of the esophagus were compared in 41 patients. Of these, 39 had chemotherapy or radiotherapy, or both, preoperatively. Overall, the 20 patients who had a blind esophagectomy through an abdominal and a cervical incision without a thoractomy tolerated the procedure quite well. Two patients died 3 and 5 wk afterward of arrhythmia and respiratory insufficiency, respectively. None of the 21 patients having an esophagectomy by means of a standard thoracotomy died. The blind esophagectomy took 1 h less to perform and required slightly more blood than the standard thoracic esophagectomy. Except for the 1 patient who died of respiratory insufficiency, it appeared that the patients not having a thoracotomy had less pulmonary complications and required less ventilator assistance. The length of stay was almost identical. The main advantages [of blind esophagectomy] were the ease of the operation, no change needed in the position of the patient and the shorter duration of the operation. Theoretic advantages, not yet confirmed, include decreased mortality and morbidity if an anastomotic leak occurs and decreased change of local recurrence of the carcinoma.

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