Transhiatal versus ivor-lewis procedure for the treatment of carcinoma oesophagus

ABSTRACT

To compare the results of Transhiatal and Ivor-Lewis operations for the treatment of Carcinoma Oesophagus. Comparative study conductedfrom 1[st] April 1999 to 30[th] March 2001. Ward 2, Jinnah Postgraduate Medical Centre, Karachi. Thirty patients with resectable carcinoma in the middle and the lower third o[the oesophaglls. The patients were randomly assigned to the two groups. Group-A patients [15] underwent Transhiata/oesophagectomy while Group-B patients [15] were operated by the Ivor-Lewis approach. The data of these patients was collected and analyzed. Student 't' test was applied for statistical significance. Among the thirty cases, 60% were male and 40% female. The average age of the patients was 55 +/- 11.29 years in Group-A and 50.53 +/- 13.83 years in Group-B. In 50% of the patients, the tumour was present in the lower 1/3 of the Oesophagus, in 46.66% in the middle 1/3 and in 3.33% patients both in the middle and the lower 1/3. Histopathology revealed that in 63.33% cases the tumour was squamous cell carcinoma, while in 36.66% it was adenocarcinoma. The mean operative time for Transhiatal Oesophagectomy was 3.75 hours, whereas it was 5.25 hours for the Ivor-Lewis procedure. There was no statistically significant difference in the result of both the procedures. We conclude that Transhiatal and Ivor-Lewis Oesophagectomies are comparable operations for resectable carcinomas of the Oesophagus