Surgical management of and long-term survival after XXXX .

@entity1 @entity5 @entity75 @entity260 @entity420
BACKGROUND: The choice of surgical strategy for @entity1 with @entity420 of the oesophagogastric junction is controversial. This study was performed to analyse the surgical results of a 20-year experience with these lesions. METHODS: From January 1981 to January 2001, 126 @entity1 with @entity420 underwent resection in the authors' institution. The treatment of choice was oesophagectomy for @entity5 , and extended gastrectomy for @entity75 . Morbidity, mortality and survival were determined retrospectively. RESULTS: Fifty-six @entity1 (44.4 per cent) had @entity5 , 44 (34.9 per cent) type II and 26 (20.6 per cent) type III. Primary resection was performed in 113 @entity1 (89.7 per cent). Oesophagectomy with resection of the proximal stomach was carried out in 65 @entity1 (51.6 per cent) and extended total gastrectomy with transhiatal resection of the distal oesophagus in 61 (48.4 per cent). In-hospital mortality and morbidity rates were 4.8 and 34.1 per cent respectively. The overall 3- and 5-year survival rates were 40.9 and 25.1 per cent respectively, and were not affected by the surgical approach. Survival was significantly associated with R0 resection, pathological node-positive category, @entity260 and @entity5 differentiation. CONCLUSION: Postoperative mortality, morbidity and long-term survival did not appear to be affected by surgical approach. Further prospective studies are needed to confirm the equivalence between transthoracic and transabdominal approaches.
