Techniques and results of XXXX surgery in Germany.

@entity834 @entity39 @entity5 @entity1208 @entity418
AIMS: This study evaluated the techniques and short-term results of surgical treatment for @entity418 in Germany by a nationwide representative survey. METHODS: In 2000 a questionnaire including 63 structured items concerning indication, technique, number of procedures, complications, and hospital mortality was sent to 308 randomly selected general, gastrointestinal, and thoracic surgeons and all university hospitals in Germany (20% of all surgeons). The response rate was 76% ( n=234). RESULTS: In 1999 the 56 participating hospitals performed approximately 370,000 procedures, including 1,677 operations for @entity1208 , including 891 esophagectomies, 706 for @entity418 , 285 for @entity5 . Gastric interposition was the most common technique to restore alimentary tract continuity (86%). Interposition of the colon (ascending colon 64%) is a common procedure only in 22 centers, indicating that experience with this means of esophageal reconstruction is limited. There were no significant differences in complication and mortality rates between gastric transposition and colon interposition. The overall complication rate was 61%, with 36% after gastric interposition and 42% after colon interposition. @entity834 occurred in 12% and 15%, respectively, and the rate of graft @entity39 was 3% in both groups. Hospital mortality was 8% with gastric transposition and 11% with colon interposition. Mean postoperative hospital stay was 24 days. CONCLUSIONS: This study indicates that gastric transposition is frequently used for reconstruction after esophageal resection for @entity5 . It appears that the colon is not as accepted as the stomach for reconstruction, although the reported complication rates compare well with those reported after gastric transposition. This study allows a realistic evaluation of the overall risk of these surgical techniques.
