ArticleCureus2025
Outcomes of Esophagectomy in a Tertiary Care Center in Pakistan.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
introductionEsophageal cancer (EC) is a disease with a poor prognosis. Surgical management, combined with chemoradiotherapy, is the standard management. However, esophagectomy is associated with high morbidity and mortality. There is limited data on esophagectomy and its outcomes in Pakistan. This study aims to address this gap in the literature. METHODOLOGY: A retrospective single-center cohort study was conducted to evaluate patients undergoing esophagectomy for EC during five years, from January 1, 2019, to December 31, 2023. Patients underwent minimally invasive esophagectomy in the form of laparoscopic-assisted Ivor-Lewis esophagectomy, or open surgery, as left thoracoabdominal esophagectomy and transhiatal esophagectomy. Data regarding intraoperative course, postoperative events, complications, and final histopathology reports were evaluated.
resultsA total of 43 patients underwent esophagectomy for EC. The mean age was 62.2 ± 12.1 years, with 31 (72.1%) male patients. Adenocarcinoma was the most common diagnosis, accounting for 27 (62.8%), with squamous cell carcinoma present in the remaining 16 (37.2%) cases. Neoadjuvant therapy was given to 37 (86.0%) patients. Mean operative time was 288 ± 88 minutes. Twenty-six (60.5%) patients had an uneventful postoperative course. Seven (16.3%) patients experienced minor deviations from the routine postoperative course and were classified as grade 1 in the Clavien-Dindo classification. Higher Clavien-Dindo grades were found in 12 (27.9%) cases, indicating greater morbidity. There were no cases of anastomotic leak or chyle leak. There was one reintervention (2.3%) and one mortality (2.3%). There was no association between the development of complications and gender (
conclusionsEsophagectomy with reasonable rates of morbidity and sound oncological outcomes is feasible in a developing country like Pakistan. Complications were found to be independent of gender, comorbidities, and the underlying pathology. Larger, prospective, and ideally multicenter studies with a longer follow-up period are needed from this region.
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