Transthoracic versus transhiatal resection for carcinoma of the esophagus:A meta-analysis

There is much controversy about the surgical approach to esophageal carcino ma: should an extensive resection be done to optimize long-term survival or should the extent of the operation be limited to obtain lower perioperativ e morbidity and mortality rates? We systematically reviewed the English-lan guage literature published during the past decade, with emphasis on the dif ferences between transthoracic and transhiatal resections regarding early m orbidity, in-hospital mortality rates, and 3- and 5-year survival. Although transthoracic resections had significantly higher early (pulmonary) morbid ity and mortality rates, 5-year survival was approximately 20% after both t ransthoracic and transhiatal resections. (C) 2001 by The Society of Thoraci c Surgeons.