Thoracoabdominal gastrectomy and distal 2/3 esophageal resection with wide lymph node dissection for type II and III adenocarcinoma at the gastro-esophageal junction
(2019) In The American Journal of Surgery 218(2). p.329-334- Abstract
Background: For locally advanced Siewert type II and III tumors we have performed total gastrectomy including resection of the distal 2/3 of the esophagus, through separate abdominal and right chest incisions (THX-ABD). The procedure involves wide lymphadenectomy in the abdomen/chest and a Roux-en-Y jejunostomy to the level of the azygos vein or above. The aim of the study was to investigate short- and long-term results for this rarely used procedure. Methods: Retrospective study of 83 radio-chemotherapy naïve patients with adenocarcinoma at the gastro-esophageal junction (Siewert type II n = 65 and type III n = 18) operated upon 1986–2011. Results: 2/83 (2.4%) patients died in hospital. 70/83 (84%) patients had R0-resections. 82/83... (More)
Background: For locally advanced Siewert type II and III tumors we have performed total gastrectomy including resection of the distal 2/3 of the esophagus, through separate abdominal and right chest incisions (THX-ABD). The procedure involves wide lymphadenectomy in the abdomen/chest and a Roux-en-Y jejunostomy to the level of the azygos vein or above. The aim of the study was to investigate short- and long-term results for this rarely used procedure. Methods: Retrospective study of 83 radio-chemotherapy naïve patients with adenocarcinoma at the gastro-esophageal junction (Siewert type II n = 65 and type III n = 18) operated upon 1986–2011. Results: 2/83 (2.4%) patients died in hospital. 70/83 (84%) patients had R0-resections. 82/83 (99%) patients had free longitudinal resection margins. Overall 5-year survival was 22/83 (27%). Conclusion: THX-ABD can be performed with high rates of R0 resections and with low in-hospital mortality. Long-term survival rate was not better compared with less extensive surgical procedures.
(Less)
- author
- Jeremiasen, Martin LU ; Walther, Bruno LU ; Djerf, Pauline LU ; Staël von Holstein, Christer LU ; Zilling, Thomas LU ; Hermansson, Michael LU ; Falkenback, Dan LU and Johansson, Jan LU
- organization
- publishing date
- 2019
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Adenocarcinoma, Gastrectomy, Gastro-esophageal junction, Lymph nodes, Thoracoabdominal
- in
- The American Journal of Surgery
- volume
- 218
- issue
- 2
- pages
- 329 - 334
- publisher
- Elsevier
- external identifiers
-
- scopus:85059563320
- pmid:30635210
- ISSN
- 0002-9610
- DOI
- 10.1016/j.amjsurg.2018.11.049
- language
- English
- LU publication?
- yes
- id
- 1ad38ed9-3e67-41f1-98d0-39aaba076bda
- date added to LUP
- 2019-01-18 14:31:22
- date last changed
- 2024-03-18 23:25:50
@article{1ad38ed9-3e67-41f1-98d0-39aaba076bda, abstract = {{<p>Background: For locally advanced Siewert type II and III tumors we have performed total gastrectomy including resection of the distal 2/3 of the esophagus, through separate abdominal and right chest incisions (THX-ABD). The procedure involves wide lymphadenectomy in the abdomen/chest and a Roux-en-Y jejunostomy to the level of the azygos vein or above. The aim of the study was to investigate short- and long-term results for this rarely used procedure. Methods: Retrospective study of 83 radio-chemotherapy naïve patients with adenocarcinoma at the gastro-esophageal junction (Siewert type II n = 65 and type III n = 18) operated upon 1986–2011. Results: 2/83 (2.4%) patients died in hospital. 70/83 (84%) patients had R0-resections. 82/83 (99%) patients had free longitudinal resection margins. Overall 5-year survival was 22/83 (27%). Conclusion: THX-ABD can be performed with high rates of R0 resections and with low in-hospital mortality. Long-term survival rate was not better compared with less extensive surgical procedures.</p>}}, author = {{Jeremiasen, Martin and Walther, Bruno and Djerf, Pauline and Staël von Holstein, Christer and Zilling, Thomas and Hermansson, Michael and Falkenback, Dan and Johansson, Jan}}, issn = {{0002-9610}}, keywords = {{Adenocarcinoma; Gastrectomy; Gastro-esophageal junction; Lymph nodes; Thoracoabdominal}}, language = {{eng}}, number = {{2}}, pages = {{329--334}}, publisher = {{Elsevier}}, series = {{The American Journal of Surgery}}, title = {{Thoracoabdominal gastrectomy and distal 2/3 esophageal resection with wide lymph node dissection for type II and III adenocarcinoma at the gastro-esophageal junction}}, url = {{http://dx.doi.org/10.1016/j.amjsurg.2018.11.049}}, doi = {{10.1016/j.amjsurg.2018.11.049}}, volume = {{218}}, year = {{2019}}, }