Transhiatal oesophagectomy: Techniques, tips and outcomes

Aim: To demonstrate our technique and valuable tips for transhiatal oesophagectomies. Method: 215 patients underwent transhiatal oesophagectomies in our unit between 2000 and 2006. Results: In-hospital mortality was 0.9%. Anastomotic leak in 12 patients (5.6%). Chyle leak was seen in five patients and recurrent nerve neuropraxia in six patients. Iatrogenic splenectomy rate was 6%. The median operative time was 151 minutes (range 93–276 minutes). Overall median length of hospital stay was 15 days (range 8–95 days). The median survival for all patients undergoing transhiatal oesophagectomy for invasive malignancy was 42.9 months and the one-year and five-year survival were 81% and 48% respectively. Conclusion: This is a safe and oncologically sound procedure. We feel that the tips can be helpful for anyone performing this procedure.