Introduction: Esophageal cancer is an invasive tumor with a poor prognosis. Unfortunately, this malignant tumor has a considerable prevalence in north part of Iran, especially near the Caspian Sea. It is also an important cause of cancer-related mortality. Surgery is the most effective approach for cure and also is used for palliation. Transmittal esophagectomy is a popular method of resection with a low morbidity and mortality.
Objective: We designed this study to document the clinic pathologic characteristics of patients undergoing this procedure for esophageal cancer and to determine the contributing factors survival of patients.
Materials and Methods: This descriptive study was performed between 1993 and first half of 2003 on 162 patients in Rasht Razi hospital. Patients’ medical records were surveyed regarding their age, sex, stage of dysphagia, complications of surgery, mortality, stage of cancer and level of survival. Data were analyzed by EPI-6 software.
Results: There were 102 male and 60 female patients. The mean age of patients was 57 years. 29.1% of them were urban versus 70.9% who were rural. The most frequent presenting symptoms were dysphagia (100%). The most common site of tumor was lower third of esophagus (56%) and cardia) 22%). 47.1% of patients required tube thoracostomy after surgery.9.8% of patients were splenectomized because of splenic injury. Recurrent nerve damage was observed in 4% of patients.18.4% of patient's required mechanical ventilation. Pneumonia, Mediastinitis and Chylothorax was observed in 10, 2 and 2% of patients respectively. 13% had anastomosis leak in neck, which was managed conservatively.83.1% of patients, were discharged from hospital in two weeks. The mean duration of hospital stay was 9.94±4.14 days.14% of patients expired during first month of hospitalization. Survival in 1,2,3,4 and 5 years were 80%, 50%, 40%, 30% and 20% respectively.
Conclusion: In this study mortality and morbidity were comparable with previous studies. On the other hand there wasn't any significant difference between results of this procedure and transthoracic approach that is used in other centers. Therefore it is recommended that transhiatal esophagectomy with appropriate selection of patients is the procedure of choice for curative and palliative means.