Dharmoon Areja, Anis Subhan, Masoom Raza Mirza, Nusrat Anis.
Transhiatal versus Ivor-Lewis procedure for the treatment of Carcinoma esophagus.
Pak J Surg Jan ;22(3):126-9.

Objective: To compare the results of Transhiatal and Ivor-Lewis operations for the treatment of Carcinoma Oesophagus. Design & Duration: Comparative study conducted from 1st April 1999 to 30th March 2001. Setting: Ward 2, Jinnah Postgraduate Medical Centre, Karachi. Patients: Thirty patients with resectable carcinoma in the middle and the lower third of the oesophagus. Methodology: The patients were randomly assigned to the two groups. Group-A patients (15) underwent Transhiatal oesophagectomy while Group-B patients (15) were operated by the Ivor-Lewis approach. The data of these patients was collected and analyzed. Student `t` test was applied for statistical significance. Results: Among the thirty cases, 60% were male and 40% female. The average age of the patients was 55±11.29 years in Group-A and 50.53±13.83 years in Group-B. In 50% of the patients, the tumour was present in the lower 1/3 of the Oesophagus, in 46.66% in the middle 1/3 and in 3.33% patients both in the middle and the lower 1/3. Histopathology revealed that in 63.33% cases the tumour was squamous cell carcinoma, while in 36.66% it was adenocarcinoma. The mean operative time for Transhiatal Oesophagectomy was 3.75 hours, whereas it was 5.25 hours for the Ivor-Lewis procedure. There was no statistically significant difference in the result of both the procedures. Conclusion: We conclude that Transhiatal and Ivor-Lewis Oesophagectomies are comparable operations for resectable carcinomas of the Oesophagus.

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