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 2014

Fingerprint

Esophageal Achalasia
Esophagectomy
Hospital Charges
Esophageal Neoplasms
Length of Stay
Hospital Mortality
Inpatients
Control Groups
Mortality
Population

Keywords

  • Achalasia
  • Esophagectomy
  • Outcomes

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

Cite this

Outcomes of Esophagectomy for Esophageal Achalasia in the United States. / Molena, Daniela; Mungo, Benedetto; Stem, Miloslawa; Feinberg, Richard L.; Lidor, Anne O.

In: Journal of Gastrointestinal Surgery, Vol. 18, No. 2, 02.2014, p. 310-317.

Research output: Contribution to journalArticle

Molena, Daniela ; Mungo, Benedetto ; Stem, Miloslawa ; Feinberg, Richard L. ; Lidor, Anne O. / Outcomes of Esophagectomy for Esophageal Achalasia in the United States. In: Journal of Gastrointestinal Surgery. 2014 ; Vol. 18, No. 2. pp. 310-317.
@article{66500fd75f544892a809000d54183d50,
title = "Outcomes of Esophagectomy for Esophageal Achalasia in the United States",
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.",
keywords = "Achalasia, Esophagectomy, Outcomes",
author = "Daniela Molena and Benedetto Mungo and Miloslawa Stem and Feinberg, {Richard L.} and Lidor, {Anne O.}",
year = "2014",
month = "2",
doi = "10.1007/s11605-013-2318-y",
language = "English (US)",
volume = "18",
pages = "310--317",
journal = "Journal of Gastrointestinal Surgery",
issn = "1091-255X",
publisher = "Springer New York",
number = "2",

}

TY - JOUR

T1 - Outcomes of Esophagectomy for Esophageal Achalasia in the United States

AU - Molena, Daniela

AU - Mungo, Benedetto

AU - Stem, Miloslawa

AU - Feinberg, Richard L.

AU - Lidor, Anne O.

PY - 2014/2

Y1 - 2014/2

N2 - 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.

AB - 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.

KW - Achalasia

KW - Esophagectomy

KW - Outcomes

UR - http://www.scopus.com/inward/record.url?scp=84895904722&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84895904722&partnerID=8YFLogxK

U2 - 10.1007/s11605-013-2318-y

DO - 10.1007/s11605-013-2318-y

M3 - Article

C2 - 23963868

AN - SCOPUS:84895904722

VL - 18

SP - 310

EP - 317

JO - Journal of Gastrointestinal Surgery

JF - Journal of Gastrointestinal Surgery

SN - 1091-255X

IS - 2

ER -