Thoracoabdominal gastrectomy and distal 2/3 esophageal resection with wide lymph node dissection for type II and III adenocarcinoma at the gastro-esophageal junction
- Resource Type
- Authors
- Bruno Walther; Martin Jeremiasen; Thomas Zilling; Dan Falkenback; Jan Johansson; Pauline Djerf; Christer Staël von Holstein; Michael Hermansson
- Source
- The American Journal of Surgery. 218:329-334
- Subject
- Adult
Male
medicine.medical_specialty
Time Factors
Esophageal Neoplasms
medicine.medical_treatment
Adenocarcinoma
030230 surgery
03 medical and health sciences
0302 clinical medicine
Gastrectomy
Stomach Neoplasms
Abdomen
medicine
Humans
Esophagus
Survival rate
Aged
Neoplasm Staging
Retrospective Studies
Aged, 80 and over
business.industry
General Medicine
Middle Aged
Thoracic Surgical Procedures
medicine.disease
Surgery
Esophagectomy
Dissection
Treatment Outcome
medicine.anatomical_structure
Lymphatic Metastasis
030220 oncology & carcinogenesis
Jejunostomy
Lymph Node Excision
Female
Lymphadenectomy
Esophagogastric Junction
Azygos vein
business
- Language
- ISSN
- 0002-9610
Background For locally advanced Siewert type II and III tumors we have performed total gastrectomy including resection of the distal 2/3 of the esophagus, through separate abdominal and right chest incisions (THX-ABD). The procedure involves wide lymphadenectomy in the abdomen/chest and a Roux-en-Y jejunostomy to the level of the azygos vein or above. The aim of the study was to investigate short- and long-term results for this rarely used procedure. Methods Retrospective study of 83 radio-chemotherapy naive patients with adenocarcinoma at the gastro-esophageal junction (Siewert type II n = 65 and type III n = 18) operated upon 1986–2011. Results 2/83 (2.4%) patients died in hospital. 70/83 (84%) patients had R0-resections. 82/83 (99%) patients had free longitudinal resection margins. Overall 5-year survival was 22/83 (27%). Conclusion THX-ABD can be performed with high rates of R0 resections and with low in-hospital mortality. Long-term survival rate was not better compared with less extensive surgical procedures.