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Ann Thorac Surg 2001;72:306-313
© 2001 The Society of Thoracic Surgeons

Reviews

Transthoracic versus transhiatal resection for carcinoma of the esophagus: a meta-analysis

Jan B.F. Hulscher, MDa, Jan G.P. Tijssen, MDb, Hugo Obertop, MDa, J. Jan B. van Lanschot, MDa a Department of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
b Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

Address reprint requests to Dr Hulscher, Department of Surgery, Academic Medical Center/University of Amsterdam, Suite G-134, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
e-mail: j.b.hulscher{at}amc.uva.nl

Abstract

There is much controversy about the surgical approach to esophageal carcinoma: should an extensive resection be done to optimize long-term survival or should the extent of the operation be limited to obtain lower perioperative morbidity and mortality rates? We systematically reviewed the English-language literature published during the past decade, with emphasis on the differences between transthoracic and transhiatal resections regarding early morbidity, in-hospital mortality rates, and 3- and 5-year survival. Although transthoracic resections had significantly higher early (pulmonary) morbidity and mortality rates, 5-year survival was approximately 20% after both transthoracic and transhiatal resections.




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