2024-03-29T15:40:50Z
https://nagoya.repo.nii.ac.jp/oai
oai:nagoya.repo.nii.ac.jp:00021391
2023-11-17T00:53:10Z
499:508:509:1826
Short-term outcomes after conventional transthoracic esophagectomy
Niwa, Yukiko
61914
Koike, Masahiko
61915
Hattori, Masashi
61916
Iwata, Naoki
61917
Takami, Hideki
61918
Hayashi, Masamichi
61919
Kanda, Mitsuro
61920
Kobayashi, Daisuke
61921
Tanaka, Chie
61922
Yamada, Suguru
61923
Fujii, Tsutomu
61924
Nakayama, Goro
61925
Sugimoto, Hiroyuki
61926
Nomoto, Shuji
61927
Fujiwara, Michitaka
61928
Kodera, Yasuhiro
61929
esophagectomy
esophageal cancer
transthoracic
outcomes
complications
2016-02
In our department, we have attempted to reduce the incidence of complications of conventional esophagectomy. The objective of this retrospective study was to report the short-term outcomes of esophagectomy. We reviewed 138 consecutive patients who had undergone subtotal esophagectomy by combined laparotomy via a 12-cm upper abdominal vertical incision combined with right anterior muscle-sparing thoracotomy from August 2010 to August 2014. Most of the cervical para-esophageal lymph node dissection was completed within the thoracic cavity. We performed three-field dissection in patients with tumors in the upper or middle third of the esophagus with clinical lymph node metastases in the superior mediastinum; the others underwent two-field dissection. We performed neck anastomoses in patients undergoing three-field dissection and thoracic anastomoses in those undergoing two-field dissection. Effective postoperative pain management was achieved with a combination of epidural anesthesia and paravertebral block. Postoperative rehabilitation was instituted for early ambulation and recovery. Enteral nutrition via a duodenal feeding tube was administered from postoperative day 2. Median hospital stay after surgery was 15 days (range, 10–129). Rates for both 30-day and in-hospital mortality were 0%. Morbidity rate for all Clavien–Dindo grades was 41.3%, whereas the morbidity rate for Clavien–Dindo grades III and IV was 7.2%. Anastomotic leakage developed in two patients (1.4%), recurrent laryngeal nerve palsy in 11 (8.0%), and pneumonia in nine (6.5%). Good short-term outcomes, especially regarding anastomotic leaks, were achieved by consistent improvements in surgical techniques, optimization of several operative procedures, and appropriate perioperative management.
departmental bulletin paper
Nagoya University Graduate School of Medicine, School of Medicine
2016-02
Nagoya Journal of Medical Science
1
78
69
78
http://hdl.handle.net/2237/23535
2186-3326
0027-7622
eng
http://www.med.nagoya-u.ac.jp/medlib/nagoya_j_med_sci/781.html