Transhiatal Oesophagectomy and Lymph Node Clearance in a Teaching Hospital
2826-2829
Correspondence
Dr R. Chidambaranath
Department of Surgery,
Fr Muller’s Hospital,
Kankanady, Mangalore,
Karnataka State, (India)
Ph: 00 91 824 2238297
E-mail: raj.chid@gmail.com
Introduction: Transhiatal Oesophagectomy for resectable oesophageal carcinoma has been gaining popularity and acceptance as a reasonably safe procedure, given the question over the choice of procedure for these patients who are nutritionally depleted and the limitations of preoperative evaluation methods. The purpose of this study was to find the lymph node retrieval rate and to assess Transhiatal Oesophagectomy (THE) as practiced in this centre as a means of node clearance.
Methods: A retrospective audit of patients who were found fit and who underwent THE between 2004 and 2008 was done. Operative notes and histopathology reports of all patients were scrutinized. A total of 16 out of 60 patients underwent the procedure. There were no major complications in these patients and no in-hospital mortality.
Results: Out of the 16 patients who were fit to undergo THE, 8 had no nodes found on HPE, 4 had 1-3 nodes and only 2 had greater than 10 nodes which were retrieved during surgery. Post-operative complications were few and there was no in-hospital mortality.
Conclusion: The transhiatal approach may not be a reliable means of removing intratoracic nodes during Oesophagectomy for carcinoma. However, a larger study directly comparing this to a transthoracic approach in the Asian population may be necessary.