Objective: Analyses of morbidity, mortality and overall survival after transhiatal (TH) or transthoracic (TT) esophagectomy.
Methods: Retrospective non randomized study of 68 patients with esophagus neoplasia operated in the Brazilian National Cancer Institute between 1997 and 2005. We divided in two groups: Group 1--TH (33 patients); and Group 2--TT (35 patients).
Results: The mean age was 40.7 years old (25-74 years old), being 73.5% male. Middle third tumors predominated in Group 2 (48.6% vs. 21.2%, p = 0,02). The mean of dissected lymph nodes was biggest in Group 2 (21.6 vs. 17.8 lymph nodes, p = 0.04), however without difference in number of metastatic lymph nodes (4.1 vs. 3.9 linfonodos, p = 0.85). The mean of operative time was higher in Group 2 (410 vs. 270 minutes, p = 0.001). Also the mean of length of stay was higher in Group 2 (19 vs. 14 days, p = 0.001). The operative morbidity was 50%, without statistical difference between the groups (42.4% vs. 57.1%, p = 0,23). Esophageal leakage occurred in 13.2% of cases, also without statistical difference (9.1% vs. 17.1%, p = 0.23). The mortality was 5.8% (04 patients), without statistical difference (1.4% vs. 4.4%, p = 0,83).
Conclusion: In our study, the morbidity and mortality showed no statistical difference in relation to the access performed, although higher operative time and length of stay were observed in TT access. The 3 and 5-years overall survival also were biggest in TT access, probably due to the biggest frequency of patients on initial stages between the submitted to the TT access.