Laparoscopic transhiatal esophagectomy in esophageal cancer patients with high-risk post-operative complications

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorTAKEDA, Flavio Roberto
dc.contributor.authorSALLUM, Rubens Antonio Aissar
dc.contributor.authorJR, Ulysses Ribeiro
dc.contributor.authorCECCONELLO, Ivan
dc.date.accessioned2022-02-24T17:15:50Z
dc.date.available2022-02-24T17:15:50Z
dc.date.issued2022
dc.description.abstractSurgical treatment of esophageal cancer is challenging, due to considerable morbidity, especially in high surgical risk patients. While transhiatal esophagectomy leads to good oncological outcomes and reduced postoperative complications, less invasive techniques might further improve outcomes. Our goal was to compare results of laparoscopic transhiatal esophagectomy (LTE) with open transhiatal esophagectomy (OTE) in esophageal cancer patients at high surgical risk. From 2014 to 2020, 128 patients were identified. Seventy received OTE while 51 received LTE. After propensity score matching (1:1), postoperative complications, analysis of overall and diseasefree survival, and survival-related prognostic factors were assessed in two groups of 48 patients. Ninety-one (77%) patients were men with a mean age of 65 +/- 10.3 years. Those who underwent OTE experienced more clinical and surgical complications. In LTE patients, the number of mean resected lymph nodes was 25.9, and in patients who had OTE, it was 17.4 (P < 0.001). Overall survival was 56.0% in the LTE group and 33.6% (P = 0.023) in the OTE group. In multivariable analysis of overall survival, open surgery and incomplete pathological response were seen as worse negative factors. In multivariable analysis, metastatic lymph nodes, incomplete pathologic response, surgical complications, and a Charlson's index > 2 (P = 0.014) were associated with poor prognosis. Both surgical methods are safe with similar morbidity and mortality; however, LTE was associated with fewer complications, a higher number of resected lymph nodes, better overall survival, and more prognostic factors related to global and disease-free overall survival in high-risk patients.eng
dc.description.indexMEDLINEeng
dc.identifier.citationDISEASES OF THE ESOPHAGUS, v.35, n.1, article ID doab022, 9p, 2022
dc.identifier.doi10.1093/dote/doab022
dc.identifier.eissn1442-2050
dc.identifier.issn1120-8694
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/44442
dc.language.isoeng
dc.publisherOXFORD UNIV PRESS INCeng
dc.relation.ispartofDiseases of the Esophagus
dc.rightsrestrictedAccesseng
dc.rights.holderCopyright OXFORD UNIV PRESS INCeng
dc.subjectcomplicationseng
dc.subjectesophageal cancerseng
dc.subjectminimal invasive esophagectomyeng
dc.subjecttranshiatal esophagectomyeng
dc.subject.othermorbidityeng
dc.subject.otherresectioneng
dc.subject.wosGastroenterology & Hepatologyeng
dc.titleLaparoscopic transhiatal esophagectomy in esophageal cancer patients with high-risk post-operative complicationseng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.citation.scopus4
hcfmusp.contributor.author-fmusphcFLAVIO ROBERTO TAKEDA
hcfmusp.contributor.author-fmusphcRUBENS ANTONIO AISSAR SALLUM
hcfmusp.contributor.author-fmusphcULYSSES RIBEIRO JUNIOR
hcfmusp.contributor.author-fmusphcIVAN CECCONELLO
hcfmusp.description.articlenumberdoab022
hcfmusp.description.issue1
hcfmusp.description.volume35
hcfmusp.origemWOS
hcfmusp.origem.pubmed33870430
hcfmusp.origem.scopus2-s2.0-85113466000
hcfmusp.origem.wosWOS:000743557000007
hcfmusp.publisher.cityCARYeng
hcfmusp.publisher.countryUSAeng
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hcfmusp.scopus.lastupdate2024-05-10
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Artigos e Materiais de Revistas Científicas - HC/ICESP
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