Page 22 - Head and neck surgery

DISADVANTAGES OF TOTAL ESOPHAGECTOMY

PLE and GPU is a one-stage three-phase operation with incisions in the neck, chest and

abdomen. One-lung ventilation is required during thoracoscopic mobilization of the thoracic

esophagus. Such an operation is a huge undertaking for elderly patients who are nutritionally

deprived with poor lung function.

Patients are prone to developing respiratory complications, pharyngo-gastric anastomotic

leakage and ischaemic gastric tube. Ischaemic stomach and anastomotic leakage can lead to

mediastinitis and mortality. Hospital mortality rate has been reported to be up to 10%.

Patients complain of early satiety and reflux after total esophagectomy and GPU.