Outcomes after Transhiatal Esophagectomies in an Eastern-European Low-Volume Center
Background: The present study proposes to analyze the results obtained after transhiatal esophagectomies (THE), from the perspective of an Eastern European surgical center with low esophageal resection volume (LV). Aims: Our analysis, which to the authors’ knowledge is the first of its kind in Ro...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Galenos Publishing House
2015-03-01
|
| Series: | Balkan Medical Journal |
| Subjects: | |
| Online Access: | http://balkanmedicaljournal.org/text.php?lang=en&id=239 |
| _version_ | 1797915380915634176 |
|---|---|
| author | Radu Neagoe Daniela Tatiana Sala Serban Bancu Septimu Voidazan Mihaly Szocs Gheorghe Mulhfay |
| author_facet | Radu Neagoe Daniela Tatiana Sala Serban Bancu Septimu Voidazan Mihaly Szocs Gheorghe Mulhfay |
| author_sort | Radu Neagoe |
| collection | DOAJ |
| description | Background: The present study proposes to analyze the results obtained after transhiatal esophagectomies (THE), from the perspective of an Eastern European surgical center with low esophageal resection volume (LV).
Aims: Our analysis, which to the authors’ knowledge is the first of its kind in Romania, has the purpose of comparing our results with those obtained in higher or similar volume centers, in order to derive conclusions regarding the quality of therapeutic management for patients diagnosed with esophageal cancer in Romania.
Study Design: Retrospective observational study.
Methods: In total, 70 patients were included, in whom THE was performed during the period 1997-2013 by six senior surgeons. The majority of our patients had esophageal cancers (n=66; 94.3%); we also performed 4 THE procedures for benign conditions (n=3; 4.27%) and esophageal perforation (n=1; 1.42%).
Results: The majority of cancer-group patients had T3/N+ tumors. The nodal involvement in the T2, T3 and T4 categories was 9.9%, 21.6% and 35.1%, respectively. Complications were identified in 45 patients (68.2%), with the majority being represented by pulmonary complications (16 patients; 24.3%) and cervical leaks (15 cases; 22.7%). In-hospital mortality was 9.09%. We found a one-year overall survival rate of 58.7% (95%CI: 51.7-65.7%), 27.2% at 2 years (95%CI: 21.2-36.2%) and 10.5% at 3 years (95%CI: 6.5-14.5%). The median survival rate was estimated to be 16 months.
Conclusion: Morbidity and in-hospital mortality after THE was performed in low-volume centers, despite being significantly higher than reported in HV centers, could be kept at reasonable rates. In our opinion, the measures which have the potential to raise the standard of care for patients diagnosed with esophageal cancer in Romania are represented by the standardization of therapeutic and diagnostic protocols for esophageal cancer and the centralization of these major oncologic interventions in surgical excellence centers. |
| first_indexed | 2024-04-10T12:40:40Z |
| format | Article |
| id | doaj.art-77fcd74233414d62b4aa34461d0ef4cb |
| institution | Directory Open Access Journal |
| issn | 2146-3123 2146-3131 |
| language | English |
| last_indexed | 2024-04-10T12:40:40Z |
| publishDate | 2015-03-01 |
| publisher | Galenos Publishing House |
| record_format | Article |
| series | Balkan Medical Journal |
| spelling | doaj.art-77fcd74233414d62b4aa34461d0ef4cb2023-02-15T16:14:17ZengGalenos Publishing HouseBalkan Medical Journal2146-31232146-31312015-03-01321384510.5152/balkanmedj.2015.15514Outcomes after Transhiatal Esophagectomies in an Eastern-European Low-Volume CenterRadu Neagoe0Daniela Tatiana Sala1Serban Bancu2Septimu Voidazan3Mihaly Szocs4Gheorghe Mulhfay5Second Department of General Surgery, Emergency Mureş County Hospital, University of Medicine and Pharmacy, Târgu Mureş, RomaniaSecond Department of General Surgery, Emergency Mureş County Hospital, University of Medicine and Pharmacy, Târgu Mureş, RomaniaSecond Department of General Surgery, Emergency Mureş County Hospital, University of Medicine and Pharmacy, Târgu Mureş, RomaniaDepartment of Epidemiology, University of Medicine and Pharmacy, Târgu Mureş, RomaniaDepartment of ENT Surgery, Emergency Mureş County Hospital, University of Medicine and Pharmacy, Târgu Mureş, RomaniaDepartment of ENT Surgery, Emergency Mureş County Hospital, University of Medicine and Pharmacy, Târgu Mureş, RomaniaBackground: The present study proposes to analyze the results obtained after transhiatal esophagectomies (THE), from the perspective of an Eastern European surgical center with low esophageal resection volume (LV). Aims: Our analysis, which to the authors’ knowledge is the first of its kind in Romania, has the purpose of comparing our results with those obtained in higher or similar volume centers, in order to derive conclusions regarding the quality of therapeutic management for patients diagnosed with esophageal cancer in Romania. Study Design: Retrospective observational study. Methods: In total, 70 patients were included, in whom THE was performed during the period 1997-2013 by six senior surgeons. The majority of our patients had esophageal cancers (n=66; 94.3%); we also performed 4 THE procedures for benign conditions (n=3; 4.27%) and esophageal perforation (n=1; 1.42%). Results: The majority of cancer-group patients had T3/N+ tumors. The nodal involvement in the T2, T3 and T4 categories was 9.9%, 21.6% and 35.1%, respectively. Complications were identified in 45 patients (68.2%), with the majority being represented by pulmonary complications (16 patients; 24.3%) and cervical leaks (15 cases; 22.7%). In-hospital mortality was 9.09%. We found a one-year overall survival rate of 58.7% (95%CI: 51.7-65.7%), 27.2% at 2 years (95%CI: 21.2-36.2%) and 10.5% at 3 years (95%CI: 6.5-14.5%). The median survival rate was estimated to be 16 months. Conclusion: Morbidity and in-hospital mortality after THE was performed in low-volume centers, despite being significantly higher than reported in HV centers, could be kept at reasonable rates. In our opinion, the measures which have the potential to raise the standard of care for patients diagnosed with esophageal cancer in Romania are represented by the standardization of therapeutic and diagnostic protocols for esophageal cancer and the centralization of these major oncologic interventions in surgical excellence centers.http://balkanmedicaljournal.org/text.php?lang=en&id=239Low-volume centermorbiditysurvival transhiatal esophagectomy |
| spellingShingle | Radu Neagoe Daniela Tatiana Sala Serban Bancu Septimu Voidazan Mihaly Szocs Gheorghe Mulhfay Outcomes after Transhiatal Esophagectomies in an Eastern-European Low-Volume Center Balkan Medical Journal Low-volume center morbidity survival transhiatal esophagectomy |
| title | Outcomes after Transhiatal Esophagectomies in an Eastern-European Low-Volume Center |
| title_full | Outcomes after Transhiatal Esophagectomies in an Eastern-European Low-Volume Center |
| title_fullStr | Outcomes after Transhiatal Esophagectomies in an Eastern-European Low-Volume Center |
| title_full_unstemmed | Outcomes after Transhiatal Esophagectomies in an Eastern-European Low-Volume Center |
| title_short | Outcomes after Transhiatal Esophagectomies in an Eastern-European Low-Volume Center |
| title_sort | outcomes after transhiatal esophagectomies in an eastern european low volume center |
| topic | Low-volume center morbidity survival transhiatal esophagectomy |
| url | http://balkanmedicaljournal.org/text.php?lang=en&id=239 |
| work_keys_str_mv | AT raduneagoe outcomesaftertranshiatalesophagectomiesinaneasterneuropeanlowvolumecenter AT danielatatianasala outcomesaftertranshiatalesophagectomiesinaneasterneuropeanlowvolumecenter AT serbanbancu outcomesaftertranshiatalesophagectomiesinaneasterneuropeanlowvolumecenter AT septimuvoidazan outcomesaftertranshiatalesophagectomiesinaneasterneuropeanlowvolumecenter AT mihalyszocs outcomesaftertranshiatalesophagectomiesinaneasterneuropeanlowvolumecenter AT gheorghemulhfay outcomesaftertranshiatalesophagectomiesinaneasterneuropeanlowvolumecenter |