caa a22 4500 445333669 CHVBK 20180317142745.0 cr unu---uuuuu 170323e20110901xx s 000 0 eng 10.1245/s10434-011-1654-y doi (NATIONALLICENCE)springer-10.1245/s10434-011-1654-y Two-Stage Operation for High-Risk Patients with Thoracic Esophageal Cancer: An Old Operation Revisited [Elektronische Daten] [Masaru Morita, Tomonori Nakanoko, Nobuhide Kubo, Yoshihiko Fujinaka, Keisuke Ikeda, Akinori Egashira, Hiroshi Saeki, Hideaki Uchiyama, Takefumi Ohga, Yoshihiro Kakeji, Ken Shirabe, Tetsuo Ikeda, Shunichi Tsujitani, Yoshihiko Maehara] Purpose: An esophagectomy followed by reconstruction for esophageal cancer is a highly aggressive operation. The purpose of this study was to justify a two-stage operation for high-risk patients with esophageal cancer. Methods: The clinical results of 27 patients who underwent two-stage operation were compared with 118 patients who underwent a simultaneous resection and reconstruction (control subjects). The reasons for the selection of the two-stage operation were underlying general disease in 13 patients (liver dysfunction, n=6; pulmonary disease, n=3; poor performance status, n=2; diabetes and renal failure, n=1 each) and high-risk operation in 14 other patients (colon interposition, n=7; salvage operation after definitive chemoradiotherapy, n=4; and intraoperative events, n=3). The patients initially underwent an esophagectomy and a cervical esophagostomy. Reconstruction was usually performed 2-3weeks later. Results: The patients in the two-stage group were older than the control patients (mean 67.8 vs. 61.6years old). The morbidity rate of the two-stage operation was 29.6%, which was not statistically different than control patients (32.2%). Postoperative complications in the two-stage operation were anastomotic leakage in 5 patients, and pneumonia and wound infection in 1 patient each. No patient experienced in-hospital death. The survival rates were not statistically different between the two groups. Conclusion: A two-stage operation is a safe operation that prevents the occurrence of critical postoperative complications, and it thus may be considered an important treatment strategy for high-risk patients with esophageal cancer. Society of Surgical Oncology, 2011 Morita Masaru Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut Nakanoko Tomonori Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut Kubo Nobuhide Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut Fujinaka Yoshihiko Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut Ikeda Keisuke Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut Egashira Akinori Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut Saeki Hiroshi Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut Uchiyama Hideaki Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut Ohga Takefumi Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut Kakeji Yoshihiro Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut Shirabe Ken Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut Ikeda Tetsuo Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut Tsujitani Shunichi Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut Maehara Yoshihiko Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut Annals of Surgical Oncology Springer-Verlag 18/9(2011-09-01), 2613-2621 1068-9265 18:9<2613 2011 18 10434 https://doi.org/10.1245/s10434-011-1654-y text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1654-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Morita Masaru Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut NATIONALLICENCE 700 1- Nakanoko Tomonori Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut NATIONALLICENCE 700 1- Kubo Nobuhide Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut NATIONALLICENCE 700 1- Fujinaka Yoshihiko Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut NATIONALLICENCE 700 1- Ikeda Keisuke Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut NATIONALLICENCE 700 1- Egashira Akinori Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut NATIONALLICENCE 700 1- Saeki Hiroshi Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut NATIONALLICENCE 700 1- Uchiyama Hideaki Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut NATIONALLICENCE 700 1- Ohga Takefumi Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut NATIONALLICENCE 700 1- Kakeji Yoshihiro Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut NATIONALLICENCE 700 1- Shirabe Ken Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut NATIONALLICENCE 700 1- Ikeda Tetsuo Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut NATIONALLICENCE 700 1- Tsujitani Shunichi Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut NATIONALLICENCE 700 1- Maehara Yoshihiko Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/9(2011-09-01), 2613-2621 1068-9265 18:9<2613 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer