Outcomes and Complications of Esophagectomy in the Management of Esophageal Cancer

Abstract

Transhiatal esophagectomy (THE) is a widely utilized surgical approach for the management of esophageal cancer, offering an alternative to transthoracic esophagectomy by avoiding thoracotomy. This review evaluates the outcomes and complications associated with THE in the treatment of esophageal cancer, synthesizing evidence from recent clinical studies and meta-analyses. The discussion focuses on oncological outcomes, including resection margins, lymph node retrieval, and survival rates, while also examining perioperative considerations such as operative time, blood loss, and recovery. Complications, including anastomotic leakage, recurrent laryngeal nerve injury, stricture formation, and pulmonary issues, are critically analyzed to understand their prevalence and impact on patient quality of life. The review highlights the comparative advantages and limitations of THE, emphasizing its role in patients with localized disease and significant comorbidities. Emerging techniques, such as minimally invasive and robotic-assisted THE, are also explored, showcasing their potential to optimize outcomes and reduce complication rates. This comprehensive analysis aims to provide clinicians with an evidence-based understanding of THE's efficacy and safety in managing esophageal cancer, guiding surgical decision-making and patient care.