Video-Assisted Transhiatal Esophagectomy in the Treatment of Esophageal Cancer

Abstract

The aim of the study was the analysis of sugical treatment of esophageal cancer using the videoassisted transhiatal esophagectomy (VTE). Material and methods. Between May 1994 and December 2001 a total of 115 patients with esophageal cancer underwent VTE. The study group included 102 men (89%) and 13 women (11%). Eighty-six (75%) had squamous cell carcinoma and 29 (25%) had adenocarcinoma. Results. The mean operative time was 4.5±1 h. Short-term complications occurred in 70 patients (60%), where the most common were pulmonary complications (27%, n=31), recurrent laryngeal nerve injury (17.4%, n=20), anastomotic stricture (14%, n=16) and anastomotic leak (10.4%, n=12). Early re-laparotomy was performed in 7 patients (6%). The hospital mortality rate was 9%. Follow-up included 86 patients. Long-term complications were present in 28 patients (33%). The most common complication was anastomotic stricture in 18 patients (21%). There was no statistical difference observed in survival betweeen patients operated on for squamous cell carcinoma or adenocarcinoma. Median postoperative survival was 10 months for squamous cell carcinoma and 16 months for adenocarcinoma. The 1-, 3-and 5-year survival rates were 42%, 10% and 5%, respectively, for squamous cell carcinoma and 63%, 16% and 0%, respectively, for adenocarcinoma. Conclusions. Video-assisted transhiatal esophagectomy is a useful method for esophageal cancer treatement. The use of this technique did not improve short-or long-term results of esophageal cancer management.