Outcome after transthoracic resection of carcinoma of the oesophagus and oesophago-gastric junction: Impact of a dedicated surgical team unit

Abstract

Aims: To assess the postoperative morbidity and mortality, length of stay and long-term survival after resection of carcinoma of the oesophagus and gastro-oesophageal junction, after establishment of a new surgical team unit between thoracic and gastroenterologic surgeons. Methods: We analysed the prospective collected data of 166 consecutive patients who underwent a transthoracic oesophageal resection between June 1997 and December 2003. Results: There were 119 men and 47 women. The median age was 63 years (range 36-81). Fifty-five patients (33%) had squamous cell carcinoma and 111 (67%) had adenocarcinoma. Postoperative complications occurred in a total of 60 patients (36%). Ten patients (6%) died postoperatively, eight (4.8%) due to medical and two (1.2%) due to surgical complications. The median postoperative length of stay was 11 days (range 6-75). The overall 3- and 5- years survival was 35.6% and 30.6% respectively. Survival was adversely affected by patient age and tumor stage. Conclusions: Concentrating resection for carcinoma of the oesophagus and oesophagogastric junction to a dedicated team of specialists, including both gastrointestinal and thoracic surgeons as well as thoracic-anaesthesiological know-how, results in acceptable complication rates as well as low mortality rates especially due to surgical complications.