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Esophageal Resection for Cancer of the Esophagus: Long-Term Function and Quality of Life
Open accessAbstract
Background Information on function and quality of life of long-term survivors after esophageal resection for carcinoma is limited. Methods Between 1972 and 1990, 359 patients underwent esophagectomy for stage I or II esophageal carcinoma at Mayo Clinic. We evaluated long-term function and quality of life in 107 of these patients (81 men and 26 women) who survived 5 or more years. Median age at operation was 62 years (range, 30 to 81 years). The operation performed was an Ivor Lewis resection in 77 patients (72%), transhiatal esophagectomy in 14 (13%), extended esophagectomy in 4 (4%), thoracoabdominal esophagectomy in 4 (4%), and other in 8 (7%). Adenocarcinoma was present in 72 patients (67%), squamous cell carcinoma in 28 (26%), and other in 7 (7%). Thirty-four patients (32%) were in postsurgical stage I, 65 (61%) in stage IIA, and 8 (8%) in stage IIB. Median survival was 10.2 years (range, 5.0 to 23.2 years). Follow-up was complete for all patients. Results Gastroesophageal reflux was present in 64 patients (60%), symptoms of dumping in 53 (50%), and dysphagia to solid food in 27 (25%). Seventeen patients (16%) were asymptomatic. Factors affecting late functional outcome were analyzed. Patients who had a cervical anastomosis had significantly fewer reflux symptoms (p < 0.05). Dumping syndrome occurred more frequently in younger patients (p < 0.05) and women (p < 0.01). Quality of life was assessed separately by the Medical Outcomes Study 36-Item Short-Form Health Survey and compared with the national norm. Scores measuring physical functioning were decreased (p < 0.01). Scores measuring ability to work, social interaction, daily activities, emotional dysfunction, perception of health, and levels of energy were similar. Mental health scores were higher (p < 0.05). Conclusions We conclude that long-term functional outcome after esophagectomy for esophageal carcinoma is affected by age, sex, and type of reconstruction. Quality of life as judged by the patients is similar to the national norm.
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“Dumping syndrome, a common complication of esophageal, gastric or bariatric surgery, includes early and late dumping symptoms.”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [4]
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“Dumping syndrome has been reported to occur in approximately 20% of patients who undergo vagotomy with pyloroplasty, in up to 40% of patients after Roux-en-Y gastric bypass or sleeve gastrectomy, and in up to 50% of patients who undergo esophagectomy (3)(4)(5)(6)(7).”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [4]
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Outcome of histologically node‐negative esophageal squamous cell carcinoma
Tabira, Y., Yasunaga, M., Sakaguchi, T., Yamaguchi, Y., Okuma, T., & Kawasuji, M. (2002) · World Journal of Surgery · doi:10.1007/s00268-002-6415-4 · Cited by 8
“These phenomenon can cause the frequent occurrence of aspiration pneumonia after esophagectomy, especially in patients who undergo gastric pull-up esophagectomy with neck anastomosis [21, 22].”
BackgroundSpecific complications and limitations of robotic esophagectomy
Abbas, A. E., & Sarkaria, I. S. (2020) · Diseases of the Esophagus · doi:10.1093/dote/doaa109 · Cited by 12
Klevebro, F., Boshier, P., Savva, K., Waller, A., Hage, L., Ni, M., Hanna, G., & Low, D. (2020) · Journal of Gastrointestinal Surgery · doi:10.1007/s11605-020-04670-y · Cited by 9
“In a retrospective study in which 83% of patients had intraoperative pyloroplasty or pyloromyotomy, 50% reported postoperative dumping symptoms.(11) A retrospective study demonstrated a statistically non-significant trend for increased dumping syndrome after pyloromyotomy or pyloroplasty.”
BackgroundSchneider, M., d'Avalos, L. V., Gerdes, S., Vetter, D., & Gutschow, C. (2025) · Diseases of the esophagus · doi:10.1093/dote/doaf090 · Cited by 8
Herbal Medicine for Dumping Syndrome: A Systematic Review and Meta-Analysis
Hong, S., Park, B., Noh, H.-S., & Choi, D.-J. (2019) · Integrative Cancer Therapies · doi:10.1177/1534735419873404 · Cited by 8
“Dietary supplements (pectin, guar gum, acarbose(25-30)), somatostatin analogs (pasireotide,(5,31-33) octreotide(31)), miglitol,(34-36) iraglutide,(37) exendin-(9-39),(38) and diazoxide(39) are prescribed for postprandial hypoglycemia or hyperglycemia caused by dumping syndrome.”
BackgroundInfluence of esophageal carcinoma operations on gastroesophageal reflux
Hu, J., Li, R., Sun, L., & Ni, Y. (2004) · The Annals of Thoracic Surgery · doi:10.1016/j.athoracsur.2003.11.056 · Cited by 8
Functional Conduit Disorder Complicating Esophagectomy
Mohiuddin, K., & Low, D. E. (2015) · Thoracic surgery clinics/Thorac. surg. clin. · doi:10.1016/j.thorsurg.2015.07.009 · Cited by 7
Park, S., Lee, H.-S., Jang, H.-J., Lee, J. Y., Joo, J., & Zo, J. (2013) · Yonsei medical journal · doi:10.3349/ymj.2013.54.2.381 · Cited by 7
Quality of life after esophageal surgery
Fernando, H. C., & Luketich, J. D. (2004) · Thoracic surgery clinics/Thorac. surg. clin. · doi:10.1016/s1547-4127(04)00024-6 · Cited by 7
“[29] McLarty A, Deschamps C, Trasek V, Allen MS, Pairo-”
BackgroundMethodLong-Term Outcomes Following Esophagectomy
Schuetz, J. A. (2000) · Chest Surgery Clinics of North America · doi:10.1016/s1052-3359(25)00527-7 · Cited by 7
Lee, J.-H., Gu, B., Song, H. H., Jang, Y.-J., & Kim, H. K. (2025) · Cancers · doi:10.3390/cancers17071052 · Cited by 6
“Further large-scale randomized controlled trials are required to validate its efficacy and long-term oncological outcomes.”
Yang, J.-C., Zhang, G., Leng, C., Chen, G., Cheng, Z., & Du, X. (2023) · Obesity Surgery · doi:10.1007/s11695-023-06863-1 · Cited by 6
“Among patient-related factors, previous studies have found that younger patients and the presence of preoperative diabetes have a higher prevalence of dumping [24, 25].”
ResultQuality of life of esophagectomized patients: adenocarcinoma versus squamous cell carcinoma.
Pereira, M. R., Lopes, L. R., & Andreollo, N. (2013) · Revista do Colégio Brasileiro de Cirurgiões · doi:10.1590/s0100-69912013000100002 · Cited by 6
Nagase, H., Yamasaki, M., Yanagimoto, Y., Kanemura, T., Higashi, S., Momose, K., Kato, R., Miyazaki, Y., Makino, T., Takahashi, T., et al. (2018) · Clinical Medicine Insights: Gastroenterology · doi:10.1177/1179552218784946 · Cited by 5
Extremely rare case of primary esophageal mucous associated lymphoid tissue lymphoma.
Malik, A., Baig, Z., Ahmed, A., Qureshi, N., & Malik, F. N. (2013) · World Journal of Gastrointestinal Endoscopy · doi:10.4253/wjge.v5.i9.446 · Cited by 5
Complementary and integrative treatments: adenotonsillar disease.
Billings, K. R., & Maddalozzo, J. (2013) · Otolaryngologic clinics of North America · doi:10.1016/j.otc.2012.12.006 · Cited by 5
Haverkort, E., Binnekade, J., Busch, O., Henegouwen, M. I. V. B., de Haan, R. D., & Gouma, D. (2010) · World Journal of Surgery · doi:10.1007/s00268-010-0786-8 · Cited by 5
“In some studies, retrospective data were used, or data were collected through postal surveys, without patient contact [8, 11, 22, 27, 28].”
Esofagectomia laparocópica transhiatal: resultados imediatos
Tinoco, R. C., Tinoco, A., El-Kadre, L., Rios, R. A., Sueth, D. M., & Pena, F. M. (2007) · doi:10.1590/s0004-28032007000200011 · Cited by 5
Kudo, K., Narumiya, K., Yagawa, Y., Maeda, S., Ota, M., Osugi, H., & Yamamoto, M. (2017) · Esophagus · doi:10.1007/s10388-017-0590-8 · Cited by 5
Transthoracic Versus Transhiatal Resection for Carcinoma of the Esophagus
Hulscher, J., & van Lanschot, J. V. (2007) · doi:10.1007/978-1-84628-474-8_25 · Cited by 5
Robb, W. B., Veziant, J., Dahan, L., Mornex, F., Barbier, E., D'Journo, X., Manfredi, S., Boige, V., Jary, M., Christou, N., et al. (2025) · European Journal of Surgical Oncology · doi:10.1016/j.ejso.2025.109736 · Cited by 4
Commentary: Practice makes perfect in cervical esophagogastric anastomosis.
Panda, N., & Morse, C. (2020) · Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/j.jtcvs.2020.04.018 · Cited by 4
Nutritional support and dietary interventions following esophagectomy: challenges and solutions
Paul, M., Baker, M., Williams, R. N., & Bowrey, D. (2017) · Nutrition and Dietary Supplements · doi:10.2147/nds.s106104 · Cited by 4
Conséquences nutritionnelles de la chirurgie digestive
Zeanandin, G., Schneider, S., & Hébuterne, X. (2012) · doi:10.1016/j.nupar.2011.12.005 · Cited by 4
Surgical repair of redundant intra-thoracic stomach after Ivor Lewis esophagectomy.
Shindel, S., Nasrallah, D. V., & Heitmiller, R. (2006) · Diseases of the esophagus · doi:10.1111/j.1442-2050.2006.00550.x · Cited by 4
Stier, A., Feith, M., Weigel, C., Schwaiger, M., Heidecke, C., & Stein, H. (2003) · World Journal of Surgery · doi:10.1007/s00268-003-7203-5 · Cited by 4
“If the passage through the interposition was investigated, this was often done qualitatively by barium radiography [1, 10].”
BackgroundSurgical therapies in Barrett's esophagus.
Lundell, L. (2003) · Gastrointestinal Endoscopy Clinics of North America · doi:10.1016/s1052-5157(03)00046-1 · Cited by 4
“Both procedures transect both vagal truncs and alter the stomach function, which may result in postoperative complications in the form of dumping and diarrhea, early satiety, and weight loss [86,87].”
BackgroundParaplegia after esophagectomy: who are the patients at risk?
Massad, M., Donahue, P. E., Rubeiz, H., Halline, A. G., Patel, A., Raghunath, T., Snow, N. J., & Geha, A. (2001) · Journal of Thoracic and Cardiovascular Surgery · doi:10.1067/mtc.2001.110175 · Cited by 4
Clinical Trials for Esophageal Carcinoma
Miller, D. L. (2000) · Chest Surgery Clinics of North America · doi:10.1016/s1052-3359(25)00523-x · Cited by 2
Function and Quality of Life after Esophageal Resection
Deschamps, C., Nichols, F., Miller, D. L., Allen, M., Trastek, V., Headrick, J. R., Mclarty, A., & Pairolero, P. (2001) · doi:10.1007/978-94-017-0829-6_32 · Cited by 4
Self-citationPost-Esophagectomy Dumping Syndrome: Assessing Quality of Life of Long-Term Survivors
Dellaportas, D., Margaris, I., Tsalavoutas, E., Gkiafi, Z., Pikouli, A., Myoteri, D., Pararas, N., Lykoudis, P. M., Nastos, C., & Pikoulis, E. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14103587 · Cited by 3
“Other symptoms commonly reported in the literature are diarrhea, abdominal cramps or discomfort, early satiety, and nausea [17,18].”
Mayer, P. K., Kao, P.-Y., Lee, Y.-C., Liao, Y.-F., Ho, W., & Ben-Arie, E. (2023) · Medicine · doi:10.1097/md.0000000000033895 · Cited by 3
“[10,11] Dumping syndrome is a condition in which the food is rapidly introduced into the intestine at a rate that is faster than normal, this usually occurs due to anatomical and physiological changes in the digestive system.”
Bolger, J., Lau, H., Yeung, J. C., & Darling, G. (2022) · Diseases of the esophagus · doi:10.1093/dote/doac061 · Cited by 3
Metadata
- Authors
- McLarty, A. J., Deschamps, C., Trastek, V. F., Allen, M. S., Pairolero, P. C., & Harmsen, W. S.
- Affiliations
- Mayo Clinic (US)
- Corresponding author
- Deschamps, Claude
- Venue
- The Annals of Thoracic Surgery
- Publisher
- Elsevier BV
- Published
- 1997-06
- Volume
- 63
- Issue
- 6
- Pages
- 1568-1571
- ISSN
- 0003-4975 (ISSN-L)
- OpenAlex
- W2094315259
- Cited by
- 272
- References
- 0
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 4 · 2023: 5 · 2022: 7 · 2021: 5 · 2020: 11 · 2019: 9 · 2018: 5 · 2017: 7 · 2016: 8 · 2015: 14 · 2014: 7 · 2013: 15 · 2012: 17
- FWCI
- 4.89
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Annals of Thoracic Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Esophageal Cancer Research and Treatment
- Health Sciences › Medicine › Surgery › Esophageal and GI Pathology
- Health Sciences › Medicine › Oncology › Gastric Cancer Management and Outcomes
- Keywords
- esophageal cancer, esophagectomy, long-term functional outcome, quality of life, gastroesophageal reflux, dumping syndrome, dysphagia, cervical anastomosis, esophageal reconstruction, adenocarcinoma, squamous cell carcinoma, physical function, age and sex effects, late complications, long-term survivors, SF-36
- MeSH terms
- Actuarial Analysis, Adenocarcinoma, Adult, Age Factors, Aged, Aged, 80 and over, Carcinoma, Squamous Cell, Cause of Death, Deglutition, Deglutition Disorders, Esophageal Neoplasms, Female, Follow-Up Studies, Heartburn, Humans, Male, Middle Aged, Neoplasm Staging, Quality of Life, Sex Factors, Survival Rate, Confidence Intervals, Esophagectomy
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