Surgical results of patients after esophageal resection or extended gastrectomy for cancer of the esophagogastric junction.
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Surgical results of patients after esophageal resection or extended gastrectomy for cancer of the esophagogastric junction. / Schumacher, G; Schmidt, S C; Schlechtweg, N; Rösch, Thomas; Sacchi, M; von Dossow, V; Chopra, S S; Pratschke, J; Zhukova, J; Stieler, J; Thuss-Patience, P; Neuhaus, P.
in: DIS ESOPHAGUS, Jahrgang 22, Nr. 5, 5, 2009, S. 422-426.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Surgical results of patients after esophageal resection or extended gastrectomy for cancer of the esophagogastric junction.
AU - Schumacher, G
AU - Schmidt, S C
AU - Schlechtweg, N
AU - Rösch, Thomas
AU - Sacchi, M
AU - von Dossow, V
AU - Chopra, S S
AU - Pratschke, J
AU - Zhukova, J
AU - Stieler, J
AU - Thuss-Patience, P
AU - Neuhaus, P
PY - 2009
Y1 - 2009
N2 - Precise classification of cancers of the esophagogastric junction according to Siewert may be difficult for the presence of Barrett's esophagus or hiatal hernia, which subsequently leads to a difficult choice of the surgical procedure of esophagectomy or gastrectomy. Ninety-six patients with such cancers were operated on in our department in 7 years. Twenty-nine patients (30.2%), classified as type I (group 1), underwent a transthoracic esophagectomy with gastric pull up. Sixty-seven patients (69.8%) classified as type II or III (group 2) underwent an extended gastrectomy. We compared the patients of both groups retrospectively for disease-free survival and postoperative complications. The general performance status of most patients was comparable in both groups and was assigned to the American Society of Anesthesiologists class II or III. Statistically significant differences between the groups were seen for the postoperative reintubation rate [group 1: 31.0% vs. group 2: 9.0% (P = 0.009)], median time for surgery [group 1: 6 (3.5-8.5) hours vs. group 2: 4.7 (2.2-11.5) hours (P = 0.001)], time in the intensive care unit [group 1: 6 (3-85) days vs. group 2: 3 (1-54) days (P = 0.001)], median hospitalization time [group 1: 23 (14-105) days vs. group 2: 18 (10-63) days (P = 0.018)]. No statistical difference was observed for the recurrence-free survival of 40% after 3 years (P = 0.311), the mortality rate, the morbidity rate (P = 0.108), surgical and respiratory complications, and the incidence of anastomotic leakage (P = 0.645). We conclude that in selected cases it may be possible to perform an extended gastrectomy for small type I cancers.
AB - Precise classification of cancers of the esophagogastric junction according to Siewert may be difficult for the presence of Barrett's esophagus or hiatal hernia, which subsequently leads to a difficult choice of the surgical procedure of esophagectomy or gastrectomy. Ninety-six patients with such cancers were operated on in our department in 7 years. Twenty-nine patients (30.2%), classified as type I (group 1), underwent a transthoracic esophagectomy with gastric pull up. Sixty-seven patients (69.8%) classified as type II or III (group 2) underwent an extended gastrectomy. We compared the patients of both groups retrospectively for disease-free survival and postoperative complications. The general performance status of most patients was comparable in both groups and was assigned to the American Society of Anesthesiologists class II or III. Statistically significant differences between the groups were seen for the postoperative reintubation rate [group 1: 31.0% vs. group 2: 9.0% (P = 0.009)], median time for surgery [group 1: 6 (3.5-8.5) hours vs. group 2: 4.7 (2.2-11.5) hours (P = 0.001)], time in the intensive care unit [group 1: 6 (3-85) days vs. group 2: 3 (1-54) days (P = 0.001)], median hospitalization time [group 1: 23 (14-105) days vs. group 2: 18 (10-63) days (P = 0.018)]. No statistical difference was observed for the recurrence-free survival of 40% after 3 years (P = 0.311), the mortality rate, the morbidity rate (P = 0.108), surgical and respiratory complications, and the incidence of anastomotic leakage (P = 0.645). We conclude that in selected cases it may be possible to perform an extended gastrectomy for small type I cancers.
KW - Humans
KW - Middle Aged
KW - Treatment Outcome
KW - Length of Stay
KW - Survival Rate
KW - Follow-Up Studies
KW - Time Factors
KW - Disease-Free Survival
KW - Cause of Death
KW - Retrospective Studies
KW - Intensive Care
KW - Postoperative Complications
KW - Anastomosis, Surgical adverse effects
KW - Lymph Node Excision
KW - Anastomosis, Roux-en-Y methods
KW - Esophageal Neoplasms surgery
KW - Esophagectomy methods
KW - Esophagogastric Junction surgery
KW - Esophagus surgery
KW - Gastrectomy methods
KW - Hospitalization
KW - Intubation, Intratracheal
KW - Jejunum surgery
KW - Pneumonia etiology
KW - Positive-Pressure Respiration
KW - Respiratory Insufficiency etiology
KW - Stomach Neoplasms surgery
KW - Humans
KW - Middle Aged
KW - Treatment Outcome
KW - Length of Stay
KW - Survival Rate
KW - Follow-Up Studies
KW - Time Factors
KW - Disease-Free Survival
KW - Cause of Death
KW - Retrospective Studies
KW - Intensive Care
KW - Postoperative Complications
KW - Anastomosis, Surgical adverse effects
KW - Lymph Node Excision
KW - Anastomosis, Roux-en-Y methods
KW - Esophageal Neoplasms surgery
KW - Esophagectomy methods
KW - Esophagogastric Junction surgery
KW - Esophagus surgery
KW - Gastrectomy methods
KW - Hospitalization
KW - Intubation, Intratracheal
KW - Jejunum surgery
KW - Pneumonia etiology
KW - Positive-Pressure Respiration
KW - Respiratory Insufficiency etiology
KW - Stomach Neoplasms surgery
M3 - SCORING: Zeitschriftenaufsatz
VL - 22
SP - 422
EP - 426
JO - DIS ESOPHAGUS
JF - DIS ESOPHAGUS
SN - 1120-8694
IS - 5
M1 - 5
ER -