|
Deep Blue at the University of Michigan >
All Collections >
Thoracic Surgery, Section of >
|
Please use this persistent URL to cite or link to this item:
|
| Title: | Transhiatal esophagectomy in the profoundly obese: implications and experience. |
| Authors: | Scipione, Christopher N.
Chang, Andrew C.
Pickens, Allan
Lau, Christine L.
Orringer, Mark B. |
| Keywords: | Obesity
Esophagectomy |
| Issue Date: | Aug-2007 |
| Publisher: | Annals of Thoracic Surgery |
| Citation: | Ann Thorac Surg 2007 Aug;84(2):376-82 <http://hdl.handle.net/2027.42/57503> |
| Abstract: | BACKGROUND: Historically, obesity contraindicated an abdominal approach to the esophagogastric junction. The technique of transhiatal esophagectomy (THE) evolved without specific regard to body habitus. The dramatic increase in obese patients requiring an esophagectomy for complications of reflux disease prompted this evaluation of the impact of obesity on the outcomes of esophagectomy to determine whether profound obesity should contraindicate the transhiatal approach. METHODS: We used our Esophagectomy Database to identify 133 profoundly obese patients (body mass index [BMI] > or = 35 kg/m2) from among 2176 undergoing a THE from 1977 to 2006. This group was matched to a randomly selected, non-obese (BMI, 18.5 to 30 kg/m2) control population of 133 patients. Intraoperative, postoperative, and long-term follow-up results were compared retrospectively. RESULTS: Profoundly obese patients had significantly greater intraoperative blood loss (mean, 492.2 mL versus 361.8 mL, p = 0.001), need for partial sternotomy (18 versus 3, p = 0.001), and frequency of recurrent laryngeal nerve injury (6 versus 0, p = 0.04). The two groups did not differ significantly in the occurrence of chylothorax, wound infection, or dehiscence rate; length of hospital stay or need for intensive care unit stay; or hospital or operative mortality. Follow-up results for dysphagia, dumping, regurgitation, and overall functional score were also comparable between the two groups. CONCLUSIONS: With appropriate instrumentation, transhiatal esophagectomy in obese patients has similar morbidity and outcomes as in non-obese patients. Obesity, even when profound, does not contraindicate a transhiatal esophagectomy. |
| URI: | http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db
=pubmed&list_uids=17643603&dopt=citation |
| PMID: | 17643603 |
| Appears in Collections: | Thoracic Surgery, Section of
Interdisciplinary and Peer-Reviewed
|
Deep Blue encourages the fair use of copyrighted material, and you are free to link to content here without asking for permission. Consult the document(s) and/or contact the copyright holder for additional rights questions and requests.
|
