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128. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

03.05. - 06.05.2011, München

Dysphagia after Esophagectomy for Esophageal Cancer: A Common Problem after Collar but not after Intrathoracic Anastomosis

Meeting Abstract

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  • Alexandra König - UKE, Allgemein-, Viszeral- und Thoraxchirurgie, Hamburg

Deutsche Gesellschaft für Chirurgie. 128. Kongress der Deutschen Gesellschaft für Chirurgie. München, 03.-06.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11dgch083

DOI: 10.3205/11dgch083, URN: urn:nbn:de:0183-11dgch0831

Published: May 20, 2011

© 2011 König.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Introduction: As overall survival after esophageal cancer surgery remains poor, postoperative quality of life has gained importance as an additional outcome parameter in recent decades. While the two most commonly used reconstructive methods, intrathoracic and collar anastomosis, have shown similar oncologic effectiveness, it remains undecided whether subsequent quality of life is different. The present analysis compares these reconstruction methods, focusing on dysphagia as the main postoperative symptom.

Materials and methods: Between 2003 and 2007, 71 patients (mean age 61.5 years; 72% male, 28% female) with complete resection of esophageal carcinomas (37 adenocarcinomas, 34 squamous cell cancers) and with long-term survival of at least 18 months were contacted and completed a modified quality of life (QoL) questionnaire (median 24.1 months after surgery) (Figure 1 [Fig. 1]). Our analysis compared the reconstruction groups using a gastric tube with either collar (group A; n=36) or high intrathoracic anastomosis (group B; n=35).

Results: Postoperatively, the rate of surgical complications of our study population was 27.8 % (anastomotic leakage 22.2%) in group A vs. 11.4 % in group B (p=0.075). The long-term follow-up showed symptoms of dysphagia in 29 patients (group A, n=20; group B, n=9; p=0.007). Significantly more patients within group A had to undergo endoscopic bougienage (13 vs. 1, p<0.0001).

Table 1 [Tab. 1]

Conclusion: High intrathoracic anastomosis appears to carry a lower risk for dysphagic symptoms compared with collar anastomosis, and should therefore be the preferred method for reconstruction after surgical resection of esophageal carcinoma.