Tehran University Medical Journal

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Background: Esophageal cancer is one of the most lethal diseases in the world. It has a high prevalence in Iran, especially in the Northern provinces. The main treatment of esophageal cancer is surgery. There are two common surgical procedures for its treatment, Transhiatal esophagectomy and transthoracic esophagectomy. The aim of this study was to compare the results of above methods in esophageal cancer. Methods: This cross-sectional study was done on patients with pathologic diagnosis of esophageal cancer that referred to surgery ward of Shahid Beheshti Hospital, in Babol, Iran in 2002-2008. Patients according to the location of tumor and physical status were undergone transhiatal or transthoracic esophagectomy. Demographic and surgical findings were recorded. The patients were matched according to age, sex, weight loss, serum albumin level and hemoglobin concentration in two groups. Results: Fifty nine percent of patients were under transhiatal esophagectomy and 41% were under transthoracic esophagectomy (n=166). Morbidity did not show significant difference (p=0.636) between transhiatal (42.9%) and transthoracic (47.1%) methods. Duration of surgery (min) in transhiatal method (180.7±35.1) was significantly (p<0.0001) lower than the transthoracic one (226.7±54.2). Duration of admission (days) did not show significant difference (p=0.44) between transhiatal esophagectomy (8±4.9) and the other method (8.5±1.6). Mortality in 30 days after surgery did not show significant difference (p=0.489) between two groups (4.1% against 7.4%). Conclusions: Based on our study, duration of surgery in transhiatal esophagectomy was lower than transthoracic method. Other parameters include morbidity, mortality, and duration of admission had not significant difference between two groups.

Keywords: Esophageal cancer, transhiatal esophagectomy, transthoracic esophagectomy, morbidity, mortality

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