Original Article

Comparison of Transhiatal and Transthoracic Approaches in Esophageal Cancer Surgery

10.5152/cjms.2020.1359

  • Orçun Yalav
  • Uğur Topal
  • Burak Yavuz
  • Kubilay Dalcı

Received Date: 23.09.2019 Accepted Date: 11.12.2019 Cyprus J Med Sci 2020;5(1):66-76

BACKGROUND/AIMS

We aimed to compare the efficacy and safety of transthoracic and transhiatal surgical approaches for esophageal cancer in our clinic.

MATERIAL and METHODS

The records of patients who underwent curative resection for esophageal cancer between 2011 and 2019 were retrospectively reviewed. Patients were divided into two groups according to the surgical approach: Group 1, transhiatal esophagectomy (THE); and Group 2, transthoracic esophagectomy (TTE). Demographics, preoperative stages, intraoperative findings, postoperative morbidity, mortality, and mean survival were compared.

RESULTS

Group 1 (THE) had 11 patients and Group 2 (TTE) had 19 patients. The groups were similar in terms of age, sex, and preoperative stage (p=0.5). Surgery duration (p=0.002) and the number of dissected lymph nodes (p=0.048) were significantly higher in the TTE group, but intraoperative blood loss (p=0.801), postoperative hospital stay (p=0.414), postoperative complication rates (p=0.734), postoperative mortality (p=0.393), and mean survival time (p=0.164) were not significantly different between the groups.

CONCLUSION

Comparing the TTE and THE surgical techniques performed for esophageal cancer in our clinic, the surgery time was longer for TTE, which allowed for more lymph node dissection; however, TTE showed similar morbidity and mortality rates as THE, and the type of surgical approach did not affect postoperative mortality, major morbidity rates, anastomosis complications, length of hospital stay, or survival time. We believe that these results are due to the low number of patients in the study, the fact that more experienced surgeons had performed THE in the first 4 years, and that esophagectomy cases were not performed by a single surgical team in our clinic.

Keywords: Esophageal cancer, transhiatal surgery, transthoracic surgery