Section V: techniques of esophageal resection.
Esophagectomy the treatment of choice for esophageal cancer, is a procedure which, nationwide, carries a mortality rate of 10% and a morbidity rate of 50%. The five-year survival rate for esophagectomy for cancer remains at 20%. With great care in surgical planning, technique, and patient care, the mortality rate has been lowered to 3% at several large academic centers. The methods of esophagectomy including Ivor-Lewis, transhiatal, left thoracoabdominal, and cervical exenteration are discussed. The technique of tri-incisional esophagectomy is detailed in this chapter. This technique combines the best aspects of the Ivor-Lewis and transhiatal approaches, those being a cervical anastomosis (avoiding an intrathoracic leak, minimizing reflux, and allowing for a complete esophagectomy) and transthoracic dissection of the esophagus (allowing for a safe dissection and complete lymphadenectomy).
Linden
Philip A
PA
Harvard Medical School, Division of Thoracic Surgery, Brigham and Women's Hospital, Boston, MA 02115, USA.
Sugarbaker
David J
DJ
D004938:Esophageal Neoplasms / Q000401:mortality / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007813:Laparotomy; D013908:Thoracotomy