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document
A prospective comparison of transthoracic and transhiatal resection for esophageal carcinoma in Asians . BACKGROUND/AIMS Transthoracic and transhiatal esophagectomy are two common procedures for esophageal cancer resection . Prospective studies comparing the two methods in Asian people are few . In addition , the data comparing their effects on the quality of life are lacking . METHODOLOGY A prospective randomized study was conducted from January 2003 . Patients of resectable esophageal cancer of comparable stage were allocated to undergo the transthoracic or transhiatal procedure in turn . They were all reconstructed with stomach interposition through the retrosternal route . Discharged patients were followed-up in the outpatient clinic . They were questioned on the topics of ( i ) severity of pain , ( ii ) ease of swallowing , ( iii ) satisfaction of daily activities , ( iv ) dependence on medications , ( v ) working ability , ( vi ) fatigue , ( vii ) appetite , ( viii ) sociality , ( ix ) happiness and ( x ) self respect , in the third , sixth and twelfth month . Also the demographic data , operative results and survival were recorded . RESULTS Up to December 2006 , eighty-seven patients of stage II and III , including 71 patients of middle third lesions and 16 lower third lesions were enrolled . The operation time was significantly longer , and the leakage rate was higher in the transthoracic group ( Student 's t-test and Fischer 's exact test , respectively ) . However , intraoperative blood loss and postoperative hospital stay were not significantly different ( Student t-test ) . Also , the Kaplan-Meier survival curves of these two groups were not significantly different by log-rank test ( p=0.286 ) . The score on the quality of life of transhiatal patients was significantly higher than that of transthoracic patients in the third , sixth and twelfth month . CONCLUSIONS Transhiatal esophagectomy is a safe and fast procedure . The survival was similar to that of transthoracic approach . Its leakage rate was lower and quality of life was better .
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Intervention_Surgical
transthoracic
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Intervention_Surgical
transhiatal resection
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Intervention_Surgical
Transthoracic
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Intervention_Surgical
transhiatal esophagectomy
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Intervention_Surgical
transthoracic
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Intervention_Surgical
transhiatal procedure
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Intervention_Surgical
stomach interposition through the retrosternal route
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Intervention_Surgical
Transhiatal esophagectomy
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Outcome_Other
quality of life
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Outcome_Pain
severity of pain
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Outcome_Physical
ease of swallowing
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Outcome_Other
satisfaction of daily activities
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Outcome_Physical
dependence on medications
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Outcome_Physical
working ability
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Outcome_Physical
fatigue
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Outcome_Physical
appetite
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Outcome_Mental
sociality
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Outcome_Mental
happiness and ( x ) self respect
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Outcome_Other
demographic data , operative results
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Outcome_Mortality
survival
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Outcome_Other
operation time
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Outcome_Physical
leakage rate
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Outcome_Physical
intraoperative blood loss
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Outcome_Other
postoperative hospital stay
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Outcome_Mortality
Kaplan-Meier survival curves
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Outcome_Other
quality of life
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Outcome_Physical
leakage rate
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Participant_Condition
esophageal carcinoma in Asians .
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Participant_Condition
Patients of resectable esophageal cancer of comparable stage
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Participant_Sample-size
eighty-seven patients of stage II and III
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Participant_Sample-size
71 patients of middle third lesions
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Participant_Sample-size
16 lower third lesions were enrolled