Outcomes of Esophagectomy for Esophageal Achalasia in the United States

Daniela Molena, Benedetto Mungo, Miloslawa Stem, Richard L. Feinberg, Anne O. Lidor

Research output: Contribution to journalArticle

Abstract

Background: While the outcomes after Heller myotomy have been extensively reported, little is known about patients with esophageal achalasia who are treated with esophagectomy. Methods: This was a retrospective analysis using the Nationwide Inpatient Sample over an 11-year period (2000-2010). Patients admitted with a primary diagnosis of achalasia who underwent esophagectomy (group 1) were compared to patients with esophageal cancer who underwent esophagectomy (group 2) during the same time period. Primary outcome was in-hospital mortality. Secondary outcomes included length of stay, postoperative complications, and total hospital charges. A propensity-matched analysis was conducted comparing the same outcomes between group 1 and well-matched controls in group 2. Results: Nine hundred sixty-three patients with achalasia and 18,003 patients with esophageal cancer underwent esophagectomy. The propensity matched analysis showed a trend toward a higher mortality in group 2 (7.8 vs. 2.9 %, p = 0.08). Postoperative length of stay and complications were similar in both groups. Total hospital charges were higher for the achalasia group ($115,087 vs. $99, 654.2, p = 0.006). Conclusion: This is the largest study to date examining outcomes after esophagectomy in patients with achalasia. Based on our findings, esophagectomy can be considered a safe option, and surgeons should not be hindered by a perceived notion of prohibitive operative risk in this patient population.

Original languageEnglish (US)
Pages (from-to)310-317
Number of pages8
JournalJournal of Gastrointestinal Surgery
Volume18
Issue number2
DOIs
StatePublished - Feb 1 2014

    Fingerprint

Keywords

  • Achalasia
  • Esophagectomy
  • Outcomes

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

Cite this