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Complications After Esophagectomy for Cancer: 53-Year Experience with 20,796 Patients

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Abstract

The incidence of esophageal cancer in Hebei Province in China is the highest in the world. Our experience in the Department of Thoracic Surgery, Fourth Hospital, Hebei Medical University with the management of postoperative complications following esophagectomy was determined. From September 1952 to December 2005, a total of 20,796 patients underwent an intended esophagectomy for cancer in our department. Data for the outcome of these procedures was sourced from reported articles in the Chinese-language literature. The data were collated to determine the incidence and outcomes of postoperative complications. The incidence of major complications declined over the period of study. The likelihood of anastomotic leakage decreased from 5.0% to 2.3%, and pulmonary complications declined from 3.2% to 1.6%. The surgical mortality rate decreased from 17.1% to 0.6%. The incidence of postoperative complications and deaths following esophagectomy for cancer in our unit has fallen steadily over the past five decades. Improvements in preoperative preparation and postoperative management have contributed to this decrease.

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References

  1. Parkin DM, Pisani P, Ferlay J (1999) Estimates of the worldwide incidence of 25 major cancers in 1990. Int J Cancer 80:827–841

    Article  PubMed  CAS  Google Scholar 

  2. Li LD, Lu FZ, Zhang SW, et al. (1996) Analysis of cancer mortality and distribution in China from year 1990 through 1992: an epidemiological study. Chin J Oncol 18:403–407

    CAS  Google Scholar 

  3. Hou J, Zhang H, Liu TG, et al. (1995) Analysis of cancer mortality in 21 counties in Hebei from year 1990 through 1992. Hebei Med J 17:20–38

    Google Scholar 

  4. Hou J, Lin PS, Chen ZF (1998) A study survey of esophageal cancer in Cixian of Hebei. Chung Liu Fang Zhi Yan Jiu 25:73–75

    Google Scholar 

  5. Zhang YD, Zhang MG, ** YM, et al. (2007) The experiences in and long-term results of surgical treatment for cancer of the esophagus and gastric cardia. Surg Esophagus 6:30–33

    Google Scholar 

  6. Liu JF, Wang QZ, Hou J (2004) Surgical treatment for cancer of the oesophagus and gastric cardia in Hebei, China. Br J Surg 91:90–98

    Article  PubMed  CAS  Google Scholar 

  7. Department of Thoracic Surgery, Fourth Hospital, Hebei Medical College (1978) Surgical treatment and its long-term results of 3694 patients with cancer of the esophagus and gastric cardia. Chung Liu Fang Zhi Yan Jiu 1:1–4

    Google Scholar 

  8. Zhang YD, Du XQ, Zhang W, et al. (1982) The experience in surgical treatment of 4310 patients with cancer of esophagus and gastric cardia. Chin J Oncol 1 4:1–4

    CAS  Google Scholar 

  9. Zhang YD, Du XQ, Zhang W, et al. (1984) Surgical treatment of cancer of the esophagus and gastric cardia. Acta Acad Med Hebei 5:21–22

    CAS  Google Scholar 

  10. Huang GJ (1991) Surgical treatment for cancer of the esophagus and gastric cardia. In: Chinese Health Ministry, editor. Criteria of Diagnosis and Treatment of Commonly Encountered Malignant Tumors in China—Carcinoma of the Esophagus and Gastric Cardia. Joint Publishing House of Bei**g Medical University and Union Medical University, Bei**g, pp 29–31

  11. Zhang YD, Du XQ, Zhang MG, et al. (1989) Surgical treatment and long-term outcomes of cancer of the oesophagus and gastric cardia. In: Proceedings of the Second China National Symposium on Oesophageal Cancer, Shijiazhuang, p 33

  12. Du XQ, Zhang YD, Yan JS, et al. (1986) Clinical experience in using the esophageal tube-shaped anastomotic stapler: a report of 150 cases. Acta Acad Med Hebei 7:152–154

    Google Scholar 

  13. Zhang YD, Chen LQ, Zhang Z (1994) The sutureless esophagogastric anastomosis by intraluminal elastic circular ligation: experimental study and clinical application. Dis Esophagus 7:215–219

    Google Scholar 

  14. Chen Y (1986) Causes, prevention and treatment of esophagogastric anastomosis. Acta Acad Med Hebei 7:1–3

    Google Scholar 

  15. ** YM, Yan JS, Du XQ, et al. (1982) Anastomotic leakage after esophagectomy and esophagogastrostomy for cancer of the esophagus and gastric cardia: an analysis of 159 cases. Chin J Oncol 4:36–38

    CAS  Google Scholar 

  16. Zhang W (1998) Complications after esophagectomy for cancer. In: Shao LF, Zhang YD, editors. Surgery of the esophagus. Hebei Science and Technology Pressing House, Shijiazhuang, pp 128–235

    Google Scholar 

  17. Han JJ, Liu H, Wang ZL (1993) Dilatation for anastomotic stenosis after esophagectomy for cancer: an analysis of 91 cases. Hebei Med J 15(Suppl):105–107

    Google Scholar 

  18. Yan Js, Li BQ, Du XQ, et al. (1989) Reoperation for severe anastomotic stenosis after reconstruction of the esophagus. Thorac Cardiovasc Surg 1:56–57

    Google Scholar 

  19. Liu JF, Li BQ, Wang FS, et al. (2001) Endoscopic placement of esophageal stent for anastomotic stenosis after esophagectomy for cancer. In: Pinotti HW, Cecconello I, Felix VN, editors. Recent Advances in Diseases of the Esophagus. Moduzzi Esitore, Bologna, pp 281–286

    Google Scholar 

  20. Wang QZ, Du XQ, Zhang YD (1985) Prevention and treatment of chylothorax after surgery for esophageal cancer. Acta Acad Med Hebei 6:95–97

    Google Scholar 

  21. Li BQ, Zhang YF, Shang XB, et al. (2001) Chylothorax after ligation of the thoracic duct in esophagectomy for cancer. Hebei Med J 23:53–54

    CAS  Google Scholar 

  22. ** YM, Zhang YD, Zhang W, et al. (1983) Diaphragmatic hernia after resection of carcinoma of the esophagus and gastric cardia. Adv Med 2:86–88

    Google Scholar 

  23. Zhang HL, Meng XL, ** YM, et al. (1993) Intrathoracic and intraabdominal bleeding after esophagectomy for cancer: report of 22 cases. Acta Acad Med Hebei 14:21–23

    CAS  Google Scholar 

  24. Zhang W, Zhang YD, Du XQ, et al. (1983) Esophagogastric anastomosis–large artery fistula: a report of 10 cases. Acta Acad Med Hebei 4:250–253

    Google Scholar 

  25. Li WQ, Zhang YD, Du XQ, et al. (1983) Pulmonary complications after esophagectomy for cancer. Adv Med Health 2:86–91

    Google Scholar 

  26. Chen LQ, Liu JP, Zhang MD, et al. (1994) Heart arrhythmia after esophagectomy for cancer: an analysis of 108 cases. Chin J Oncol 16:438–440

    CAS  Google Scholar 

  27. ** YM, He M, Chen LQ, et al. (1995) Analysis on causes of postoperative deaths following resection of cancer of the esophagus and gastric cardia. In: Proceedings of Fourth China National Symposium on Esophageal Cancer, Nanjiang, p 13

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Acknowledgments

Professor David Watson at Flinders Medical Center, Flinders University, Australia helped with the preparation of the manuscript. The study was supported by a Government Foundation grant from Hebei Provincial Department of Education.

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Correspondence to J. F. Liu.

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Liu, J.F., Wang, Q.Z., **, Y.M. et al. Complications After Esophagectomy for Cancer: 53-Year Experience with 20,796 Patients. World J Surg 32, 395–400 (2008). https://doi.org/10.1007/s00268-007-9349-z

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