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World Journal of Surgical Oncology

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Open Access 01-12-2005 | Research

Morbidity and mortality after esophagectomy for esophageal carcinoma: A risk analysis

Authors: Ines Gockel, Christoph Exner, Theodor Junginger

Published in: World Journal of Surgical Oncology | Issue 1/2005

Abstract

Background

The study was aimed to identify pre- and intraoperative risk factors that potentially influence morbidity and mortality after esophagectomy for esophageal carcinoma with particular emphasis on the predominant tumor types.

Patients and methods

Between September 1985 and March 2004, 424 patients underwent esophagectomy for esophageal carcinoma. Of these, 186 (43.9%) patients had a transhiatal, and 231 (54.5%) patients underwent a transthoracic procedure with two-field lymphadenectomy. Pre-, intraoperative risk factors and tumor characteristics were included in the risk analysis to assess their influence on postoperative morbidity and mortality.

Results

Multivariate analysis (logistic regression model) identified the surgical procedure as the most important risk factor for postoperative morbidity and mortality with the transthoracic technique associated with a significant higher risk. The comparison of the risk profile between the different histological tumor types, a significantly higher nutritional risk, poorer preoperative lung function and a higher prevalence of hepatopathy was observed in patients with squamous cell carcinoma (n = 229) compared to adenocarcinoma (n = 150) (p < 0.05). Although there was no significant difference in surgical complications between the two groups, the rate of general complications, length of postoperative intensive care unit-stay and mortality rate was significantly higher in patients with squamous cell carcinoma (p < 0.05).

Conclusion

The present risk analysis shows that the selection and the type of the surgical procedure are crucial factors for both the incidence of postoperative complications and the mortality rate. The higher risk of the transthoracic procedure is justified with a view to a better long term prognosis.

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Title: Morbidity and mortality after esophagectomy for esophageal carcinoma: A risk analysis
Authors: Ines Gockel
Christoph Exner
Theodor Junginger
Publication date: 01-12-2005
Publisher: BioMed Central
Published in: World Journal of Surgical Oncology / Issue 1/2005
Electronic ISSN: 1477-7819
DOI: https://doi.org/10.1186/1477-7819-3-37

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Morbidity and mortality after esophagectomy for esophageal carcinoma: A risk analysis

Abstract

Background

Patients and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Patients and methods

Results

Conclusion

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