ArticleJournal of cardiothoracic surgery2026
Outcomes after laparoscopic transhiatal esophagectomy for siewert type I esophagogastric junction adenocarcinoma: a retrospective cohort study.
Article in Journal of cardiothoracic surgery, 2026. 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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Abstract
backgroundSiewert type I esophagogastric junction (EGJ) adenocarcinoma remains surgically challenging, and the role of transhiatal esophagectomy (THE) is debated, particularly in high-incidence and resource-variable settings.
methodsThis two-center retrospective cohort study included 101 adults with Siewert type I EGJ adenocarcinoma who underwent laparoscopic THE (January 2020–December 2022). Perioperative morbidity (Clavien–Dindo), 90-day mortality, and stage-stratified overall survival (OS) and disease-free survival (DFS) were assessed; neoadjuvant treatment varied in routine practice. OS/DFS were estimated using Kaplan–Meier methods and compared by log-rank tests. Prespecified time-point endpoints (OS status at 36 months; DFS status at 18 months) were modeled using multivariable logistic regression.
resultsMean age was 63.4 ± 8.9 years and 64.4% were male. Overall 90-day morbidity occurred in 47.5% and 90-day mortality was 7.9%. Pneumonia/aspiration occurred in 14.9%, delayed gastric emptying in 23.8%, and cervical anastomotic leak in 3.9% (managed non-operatively). R0 resection was achieved in 95.0% with a median lymph node yield of 11. Stage-stratified survival differed significantly (log-rank p < 0.001); three-year OS for pathologic stage III was 30%. At 18 months, DFS was 70% for stage 0–I and 54% for stage II–III. Advanced pathologic stage (II–III vs. 0–I) was independently associated with worse OS status at 36 months (OR 3.94; p < 0.001) and DFS status at 18 months (OR 3.39; p < 0.001).
conclusionsIn this single-arm cohort, laparoscopic THE was associated with perioperative outcomes and stage-dependent survival estimates. In the absence of a comparative transthoracic cohort, findings should be interpreted descriptively and support prospective comparative studies incorporating long-term and patient-centered outcomes.
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