Vagal-sparing esophagectomy: the ideal operation for intramucosal adenocarcinoma and barrett with high-grade dysplasia
Our aim was to compare outcome of vagal-sparing esophagectomy with transhiatal and en bloc esophagectomy in patients with intramucosal adenocarcinoma or high-grade dysplasia. Intramucosal adenocarcinoma and high grade dysplasia have a low likelihood of lymphatic or systemic metastases and esophagect...
Gespeichert in:
| Veröffentlicht in: | Annals of surgery 2007-10, Vol.246 (4), p.665-674 |
|---|---|
| Hauptverfasser: | , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 674 |
|---|---|
| container_issue | 4 |
| container_start_page | 665 |
| container_title | Annals of surgery |
| container_volume | 246 |
| creator | Peyre, Christian G DeMeester, Steven R Rizzetto, Christian Bansal, Neeraj Tang, Andrew L Ayazi, Shahin Leers, Jessica M Lipham, John C Hagen, Jeffrey A DeMeester, Tom R |
| description | Our aim was to compare outcome of vagal-sparing esophagectomy with transhiatal and en bloc esophagectomy in patients with intramucosal adenocarcinoma or high-grade dysplasia.
Intramucosal adenocarcinoma and high grade dysplasia have a low likelihood of lymphatic or systemic metastases and esophagectomy is curative in most patients. However, traditional esophagectomy is associated with significant morbidity and altered gastrointestinal function. A vagal-sparing esophagectomy offers the advantages of complete disease removal with the potential for reduced morbidity and a better functional outcome.
Retrospective review of outcome in patients with intramucosal adenocarcinoma or high grade dysplasia that had a vagal-sparing (n=49), transhiatal (n=39) or en bloc (n=21) esophagectomy.
The length of hospital stay and the incidence of major complications was significantly reduced with a vagal-sparing esophagectomy compared with a transhiatal or en bloc resection. Further, postvagotomy dumping and diarrhea symptoms were significantly less common, and weight was better maintained postoperatively with a vagal-sparing esophagectomy. Recurrent cancer has developed in only 1 patient.
Survival with intramucosal adenocarcinoma or Barrett's with high-grade dysplasia is independent of the type of resection. A vagal-sparing esophagectomy is associated with significantly less perioperative morbidity and a shorter hospital stay than a transhiatal or en bloc esophagectomy. Further, late morbidity including weight loss, dumping, and diarrhea are significantly less likely after a vagal-sparing approach. Consequently a vagal-sparing esophagectomy is the preferred procedure for patients with intramucosal adenocarcinoma or high grade dysplasia. |
| doi_str_mv | 10.1097/SLA.0b013e318155a7a1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_68306358</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>68306358</sourcerecordid><originalsourceid>FETCH-LOGICAL-c169t-58b8ca9992736d8bcd8cfa6dbcee5849b59dba5b04ecdc821e9a8504cadcb83b3</originalsourceid><addsrcrecordid>eNpdkLtOxDAURF2AeP8BQq7oAvY6Tmw6hHhJK1HwaKNr-25ilMTB9oL27wliJSSqKebMFIeQU84uONP15fPy-oIZxgUKrriUUAPfIQeMMVGUWiz2yWFK74zxUrF6j-zzWmkhmTggn2_QQl-kCaIfW4opTB20aHMYNlc0d0i9Q-hpmDBC9mGkqxCpH3OEYW1DmitwOAYL0foxDEBhdNRAjJgz_fK5o51vu6KNM0bdJk09JA_HZHcFfcKTbR6R17vbl5uHYvl0_3hzvSwsr3QupDLKgtZ6UYvKKWOdsiuonLGIUpXaSO0MSMNKtM6qBUcNSrLSgrNGCSOOyPnv7xTDxxpTbgafLPY9jBjWqamUYJWQagbLX9DGkFLEVTNFP0DcNJw1P46b2XHz3_E8O9v-r82A7m-0FSy-AVO9fwc</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>68306358</pqid></control><display><type>article</type><title>Vagal-sparing esophagectomy: the ideal operation for intramucosal adenocarcinoma and barrett with high-grade dysplasia</title><source>MEDLINE</source><source>Journals@Ovid Complete</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><creator>Peyre, Christian G ; DeMeester, Steven R ; Rizzetto, Christian ; Bansal, Neeraj ; Tang, Andrew L ; Ayazi, Shahin ; Leers, Jessica M ; Lipham, John C ; Hagen, Jeffrey A ; DeMeester, Tom R</creator><creatorcontrib>Peyre, Christian G ; DeMeester, Steven R ; Rizzetto, Christian ; Bansal, Neeraj ; Tang, Andrew L ; Ayazi, Shahin ; Leers, Jessica M ; Lipham, John C ; Hagen, Jeffrey A ; DeMeester, Tom R</creatorcontrib><description>Our aim was to compare outcome of vagal-sparing esophagectomy with transhiatal and en bloc esophagectomy in patients with intramucosal adenocarcinoma or high-grade dysplasia.
Intramucosal adenocarcinoma and high grade dysplasia have a low likelihood of lymphatic or systemic metastases and esophagectomy is curative in most patients. However, traditional esophagectomy is associated with significant morbidity and altered gastrointestinal function. A vagal-sparing esophagectomy offers the advantages of complete disease removal with the potential for reduced morbidity and a better functional outcome.
Retrospective review of outcome in patients with intramucosal adenocarcinoma or high grade dysplasia that had a vagal-sparing (n=49), transhiatal (n=39) or en bloc (n=21) esophagectomy.
The length of hospital stay and the incidence of major complications was significantly reduced with a vagal-sparing esophagectomy compared with a transhiatal or en bloc resection. Further, postvagotomy dumping and diarrhea symptoms were significantly less common, and weight was better maintained postoperatively with a vagal-sparing esophagectomy. Recurrent cancer has developed in only 1 patient.
Survival with intramucosal adenocarcinoma or Barrett's with high-grade dysplasia is independent of the type of resection. A vagal-sparing esophagectomy is associated with significantly less perioperative morbidity and a shorter hospital stay than a transhiatal or en bloc esophagectomy. Further, late morbidity including weight loss, dumping, and diarrhea are significantly less likely after a vagal-sparing approach. Consequently a vagal-sparing esophagectomy is the preferred procedure for patients with intramucosal adenocarcinoma or high grade dysplasia.</description><identifier>ISSN: 0003-4932</identifier><identifier>DOI: 10.1097/SLA.0b013e318155a7a1</identifier><identifier>PMID: 17893503</identifier><language>eng</language><publisher>United States</publisher><subject>Adenocarcinoma - surgery ; Aged ; Barrett Esophagus - surgery ; Body Weight - physiology ; Diarrhea - prevention & control ; Dumping Syndrome - prevention & control ; Esophageal Neoplasms - surgery ; Esophagectomy - methods ; Esophagus - physiopathology ; Female ; Follow-Up Studies ; Hospitalization ; Humans ; Length of Stay ; Male ; Middle Aged ; Neoplasm Recurrence, Local - pathology ; Postoperative Complications - prevention & control ; Retrospective Studies ; Survival Rate ; Treatment Outcome ; Vagus Nerve - physiology</subject><ispartof>Annals of surgery, 2007-10, Vol.246 (4), p.665-674</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c169t-58b8ca9992736d8bcd8cfa6dbcee5849b59dba5b04ecdc821e9a8504cadcb83b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17893503$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Peyre, Christian G</creatorcontrib><creatorcontrib>DeMeester, Steven R</creatorcontrib><creatorcontrib>Rizzetto, Christian</creatorcontrib><creatorcontrib>Bansal, Neeraj</creatorcontrib><creatorcontrib>Tang, Andrew L</creatorcontrib><creatorcontrib>Ayazi, Shahin</creatorcontrib><creatorcontrib>Leers, Jessica M</creatorcontrib><creatorcontrib>Lipham, John C</creatorcontrib><creatorcontrib>Hagen, Jeffrey A</creatorcontrib><creatorcontrib>DeMeester, Tom R</creatorcontrib><title>Vagal-sparing esophagectomy: the ideal operation for intramucosal adenocarcinoma and barrett with high-grade dysplasia</title><title>Annals of surgery</title><addtitle>Ann Surg</addtitle><description>Our aim was to compare outcome of vagal-sparing esophagectomy with transhiatal and en bloc esophagectomy in patients with intramucosal adenocarcinoma or high-grade dysplasia.
Intramucosal adenocarcinoma and high grade dysplasia have a low likelihood of lymphatic or systemic metastases and esophagectomy is curative in most patients. However, traditional esophagectomy is associated with significant morbidity and altered gastrointestinal function. A vagal-sparing esophagectomy offers the advantages of complete disease removal with the potential for reduced morbidity and a better functional outcome.
Retrospective review of outcome in patients with intramucosal adenocarcinoma or high grade dysplasia that had a vagal-sparing (n=49), transhiatal (n=39) or en bloc (n=21) esophagectomy.
The length of hospital stay and the incidence of major complications was significantly reduced with a vagal-sparing esophagectomy compared with a transhiatal or en bloc resection. Further, postvagotomy dumping and diarrhea symptoms were significantly less common, and weight was better maintained postoperatively with a vagal-sparing esophagectomy. Recurrent cancer has developed in only 1 patient.
Survival with intramucosal adenocarcinoma or Barrett's with high-grade dysplasia is independent of the type of resection. A vagal-sparing esophagectomy is associated with significantly less perioperative morbidity and a shorter hospital stay than a transhiatal or en bloc esophagectomy. Further, late morbidity including weight loss, dumping, and diarrhea are significantly less likely after a vagal-sparing approach. Consequently a vagal-sparing esophagectomy is the preferred procedure for patients with intramucosal adenocarcinoma or high grade dysplasia.</description><subject>Adenocarcinoma - surgery</subject><subject>Aged</subject><subject>Barrett Esophagus - surgery</subject><subject>Body Weight - physiology</subject><subject>Diarrhea - prevention & control</subject><subject>Dumping Syndrome - prevention & control</subject><subject>Esophageal Neoplasms - surgery</subject><subject>Esophagectomy - methods</subject><subject>Esophagus - physiopathology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Postoperative Complications - prevention & control</subject><subject>Retrospective Studies</subject><subject>Survival Rate</subject><subject>Treatment Outcome</subject><subject>Vagus Nerve - physiology</subject><issn>0003-4932</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkLtOxDAURF2AeP8BQq7oAvY6Tmw6hHhJK1HwaKNr-25ilMTB9oL27wliJSSqKebMFIeQU84uONP15fPy-oIZxgUKrriUUAPfIQeMMVGUWiz2yWFK74zxUrF6j-zzWmkhmTggn2_QQl-kCaIfW4opTB20aHMYNlc0d0i9Q-hpmDBC9mGkqxCpH3OEYW1DmitwOAYL0foxDEBhdNRAjJgz_fK5o51vu6KNM0bdJk09JA_HZHcFfcKTbR6R17vbl5uHYvl0_3hzvSwsr3QupDLKgtZ6UYvKKWOdsiuonLGIUpXaSO0MSMNKtM6qBUcNSrLSgrNGCSOOyPnv7xTDxxpTbgafLPY9jBjWqamUYJWQagbLX9DGkFLEVTNFP0DcNJw1P46b2XHz3_E8O9v-r82A7m-0FSy-AVO9fwc</recordid><startdate>200710</startdate><enddate>200710</enddate><creator>Peyre, Christian G</creator><creator>DeMeester, Steven R</creator><creator>Rizzetto, Christian</creator><creator>Bansal, Neeraj</creator><creator>Tang, Andrew L</creator><creator>Ayazi, Shahin</creator><creator>Leers, Jessica M</creator><creator>Lipham, John C</creator><creator>Hagen, Jeffrey A</creator><creator>DeMeester, Tom R</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200710</creationdate><title>Vagal-sparing esophagectomy: the ideal operation for intramucosal adenocarcinoma and barrett with high-grade dysplasia</title><author>Peyre, Christian G ; DeMeester, Steven R ; Rizzetto, Christian ; Bansal, Neeraj ; Tang, Andrew L ; Ayazi, Shahin ; Leers, Jessica M ; Lipham, John C ; Hagen, Jeffrey A ; DeMeester, Tom R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c169t-58b8ca9992736d8bcd8cfa6dbcee5849b59dba5b04ecdc821e9a8504cadcb83b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adenocarcinoma - surgery</topic><topic>Aged</topic><topic>Barrett Esophagus - surgery</topic><topic>Body Weight - physiology</topic><topic>Diarrhea - prevention & control</topic><topic>Dumping Syndrome - prevention & control</topic><topic>Esophageal Neoplasms - surgery</topic><topic>Esophagectomy - methods</topic><topic>Esophagus - physiopathology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local - pathology</topic><topic>Postoperative Complications - prevention & control</topic><topic>Retrospective Studies</topic><topic>Survival Rate</topic><topic>Treatment Outcome</topic><topic>Vagus Nerve - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Peyre, Christian G</creatorcontrib><creatorcontrib>DeMeester, Steven R</creatorcontrib><creatorcontrib>Rizzetto, Christian</creatorcontrib><creatorcontrib>Bansal, Neeraj</creatorcontrib><creatorcontrib>Tang, Andrew L</creatorcontrib><creatorcontrib>Ayazi, Shahin</creatorcontrib><creatorcontrib>Leers, Jessica M</creatorcontrib><creatorcontrib>Lipham, John C</creatorcontrib><creatorcontrib>Hagen, Jeffrey A</creatorcontrib><creatorcontrib>DeMeester, Tom R</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Peyre, Christian G</au><au>DeMeester, Steven R</au><au>Rizzetto, Christian</au><au>Bansal, Neeraj</au><au>Tang, Andrew L</au><au>Ayazi, Shahin</au><au>Leers, Jessica M</au><au>Lipham, John C</au><au>Hagen, Jeffrey A</au><au>DeMeester, Tom R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Vagal-sparing esophagectomy: the ideal operation for intramucosal adenocarcinoma and barrett with high-grade dysplasia</atitle><jtitle>Annals of surgery</jtitle><addtitle>Ann Surg</addtitle><date>2007-10</date><risdate>2007</risdate><volume>246</volume><issue>4</issue><spage>665</spage><epage>674</epage><pages>665-674</pages><issn>0003-4932</issn><abstract>Our aim was to compare outcome of vagal-sparing esophagectomy with transhiatal and en bloc esophagectomy in patients with intramucosal adenocarcinoma or high-grade dysplasia.
Intramucosal adenocarcinoma and high grade dysplasia have a low likelihood of lymphatic or systemic metastases and esophagectomy is curative in most patients. However, traditional esophagectomy is associated with significant morbidity and altered gastrointestinal function. A vagal-sparing esophagectomy offers the advantages of complete disease removal with the potential for reduced morbidity and a better functional outcome.
Retrospective review of outcome in patients with intramucosal adenocarcinoma or high grade dysplasia that had a vagal-sparing (n=49), transhiatal (n=39) or en bloc (n=21) esophagectomy.
The length of hospital stay and the incidence of major complications was significantly reduced with a vagal-sparing esophagectomy compared with a transhiatal or en bloc resection. Further, postvagotomy dumping and diarrhea symptoms were significantly less common, and weight was better maintained postoperatively with a vagal-sparing esophagectomy. Recurrent cancer has developed in only 1 patient.
Survival with intramucosal adenocarcinoma or Barrett's with high-grade dysplasia is independent of the type of resection. A vagal-sparing esophagectomy is associated with significantly less perioperative morbidity and a shorter hospital stay than a transhiatal or en bloc esophagectomy. Further, late morbidity including weight loss, dumping, and diarrhea are significantly less likely after a vagal-sparing approach. Consequently a vagal-sparing esophagectomy is the preferred procedure for patients with intramucosal adenocarcinoma or high grade dysplasia.</abstract><cop>United States</cop><pmid>17893503</pmid><doi>10.1097/SLA.0b013e318155a7a1</doi><tpages>10</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0003-4932 |
| ispartof | Annals of surgery, 2007-10, Vol.246 (4), p.665-674 |
| issn | 0003-4932 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_68306358 |
| source | MEDLINE; Journals@Ovid Complete; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Adenocarcinoma - surgery Aged Barrett Esophagus - surgery Body Weight - physiology Diarrhea - prevention & control Dumping Syndrome - prevention & control Esophageal Neoplasms - surgery Esophagectomy - methods Esophagus - physiopathology Female Follow-Up Studies Hospitalization Humans Length of Stay Male Middle Aged Neoplasm Recurrence, Local - pathology Postoperative Complications - prevention & control Retrospective Studies Survival Rate Treatment Outcome Vagus Nerve - physiology |
| title | Vagal-sparing esophagectomy: the ideal operation for intramucosal adenocarcinoma and barrett with high-grade dysplasia |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-26T20%3A53%3A55IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Vagal-sparing%20esophagectomy:%20the%20ideal%20operation%20for%20intramucosal%20adenocarcinoma%20and%20barrett%20with%20high-grade%20dysplasia&rft.jtitle=Annals%20of%20surgery&rft.au=Peyre,%20Christian%20G&rft.date=2007-10&rft.volume=246&rft.issue=4&rft.spage=665&rft.epage=674&rft.pages=665-674&rft.issn=0003-4932&rft_id=info:doi/10.1097/SLA.0b013e318155a7a1&rft_dat=%3Cproquest_cross%3E68306358%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=68306358&rft_id=info:pmid/17893503&rfr_iscdi=true |