TRANSHIATAL ESOPHAGECTOMY AND QUALITY OF LIFE ASSESSMENT

Abstract

Tumors of the esophagus is among the most challenging problems confronting the surgeons, because of its frequently late presentation. Most frequent presenting symptom is dysphagia which leads patient into low grade performance status. The 'quality life years' should be taken in to consideration as well as or even more than survival before selecting appropriate surgical technique. Between 1994-1997, 13 patients with locally invasive esophageal carcinoma treated by transhiatal esophagectomy plus adjuvant chemoradiotherapy were included to this study. Patients were followed up on 1., 3. and 6th month postoperatively and every 6 month then after. During these periods disphagia staging and WHO performance status recorded besides endoscopy and tumor marker (CEA and CA-19-9) analysis. Disphagia stage was S 0 until 24th month where 1 out of 5 patients was S I. On 36th month 1 patient out of 2 was SI disphagia. Performance grading was more than Grade III most of the patients on admittance and on 12th month 7 patients out of 8 was Grade I on 24th month 5 patients out of 5 was Grade I. As a conclusion transhiatal esophagectomy with shorter operation time, less demanding technique, lower operative and postoperative mortality and complication rate and with its fast course taking to the quality life, should be the surgical phase of the modern multimodality therapy of locally invasive esophageal carcinoma.