Mary M. Young, Claude Deschamps, Victor F. Trastek, Mark S. Allen, Daniel L. Miller*, Peter C. Pairolero

Mayo Clinic and Foundation

Rochester, Minnesota, USA

Esophagectomy for benign disease is performed infrequently. We reviewed the Mayo Clinic’s experience with patients who required esophageal resection and reconstruction for benign esophageal disease.

From March 1956 to October 1997, all patients who required resection for a benign primary condition of the esophagus were reviewed.

There were 255 patients (141 males, 114 females). Median age was 55 years (range, 2-100). Original diagnosis was an esophageal stricture in 108 patients (42%), primary motility disorder in 84 (33%), perforation in 36 (14%), hiatal hernia in 18 (7%), and other in 9 (4%). Indications for operation were dysphasia in 198 (78%), perforation in 33 (13%), gastrointestinal discontinuity in 16 (6%), bleeding in 5 (2%), other in 3 (1%). Reconstruction was with stomach in 168 patients (66%), colon in 70 (27%), and small bowel in 17 (7%). The anastomosis was intrathoracic in 144 patients (57%), and cervical in 111 (43%). There were 13 postoperative deaths (mortality 5%); 142 patients (56%) had at least one complication. Median hospitalization was 14 days (range, 6-95 days). Follow-up was complete in 218 patients (85%) for a median of 52 months (range, 1 month to 29 years). One hundred sixty-seven patients (77%) were improved. Functional results were classified as excellent or good in 86 patients (40%), fair in 81 (37%) and poor in 51 (23%).

Functional results after esophagectomy for complex benign disease resulted in functional improvement in a majority of patients. Although operative mortality is low, morbidity remains significant.