Trans-Thoracic versus Trans-Hiatal Esophagectomy Complications and Outcomes in Patients with Esophageal Cancer in Shohada-E-Tajrish Hospital, Tehran, Iran;2000-2008

Background: Esophageal cancer is a poor-prognosis cancer which is common in Iran. The main treatment for this cancer is surgery which may be performed with either trans-thoracic (TTE) or trans-hiatal esophagectomy (THE). Each of these methods has some specific complications, morbidity and mortality rate, leading to controversies in method selection. Therefore, in this study we evaluated the outcomes of these two approaches in Iranian patients. Methods: In this retrospective survey, we evaluated 100 patients with esophageal cancer who underwent either TTE or THE in Shohada-e-Tajrish Hospital, Tehran, from 2000 to 2008 and categorized them into two groups. The patients in the two groups were compared according to age, sex, tumor location and histopathologic characteristics, surgery results and complications, morbidity, mortality and death results. Results: Sixty nine percent (69%) of patients had squamous cell carcinoma (SCC) and 59% had undergone THE. The mean age of the patients was 61.18 years. There was no difference in age, sex distribution, tumor pathology and location in the two groups. Although neck leakage of anastomoses was more frequent in THE (7.31% vs 10.16%), there was no statistically significant difference between the two groups in complications and mortality. Duration of the surgery was longer in TTE. Conclusions: Trans-hiatal and trans-thoracic esophagectomy are the same in outcomes. Both methods can be considered as therapeutic surgical approach regarding to physician's opinion and patient's situations.