Amer Bilal, Muhammad Salim Khan, Muhammad Imran.
Two Years Followup of 1503 Cases of Esophagectomy Over a Period of 12 Years.
Esculapio J Services Inst Med Sci Jan ;13(4):203-8.

Objectives: To determine the early outcomes of 1503 esophagectomies over a period of 12 years. Methods: Computerized clinical data of 1503 cases of Esophagectomy for carcinoma esophagus from June 2002 to May 2014 was retrospectively analyzed. All patients had CT Thorax/ upper abdomen with oral and IV contrast. The operative approaches included left thoracolaparotomy with left neck anastamosis, transhiatal, left thoracolapratomy Reux en-Y, Mckeown with right Thoracotomy, Ivor Lewis and left thoracolaparotomy with left decortication. All operations were done by one surgical team. Results: Out of 1503 patients, 1077 were males and 426 were females with a mean age of 51.6 years. The age range was 17 to 80 years. Out of 1503 cases, 907 had lower one third tumors. 587 had middle one third tumors. Out of 907 lower one third tumors, stomach involvement was present in 312 cases. Histopathology reports showed adenocarcinoma in 802 specimens, squamous cell carcinoma in 682, adenosquamous was 9 and carcinoma in-situe reported in one case. Morbidity was 6% and comprised anastomotic leak in 30 cases, pulmonary complications in 33, wound infection 13, hoarseness 12 and anastomotic strictures developed in 17 cases. Mortality was 2.5% and included aspiration pneumonia respiratory failure in 10 cases, myocardial infarction in 8 cases, anastomotic leak 8, tracheal injury 3 and presumed myocardial infarction in 7 cases. Conclusion: In our experience 1503 cases in 12 years is a very high volume of esophageal workload for malignancy. Our morbidity of 6% and mortality of 2.5% shows that such major operations can be done safely in high volume thoracic centers.

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