Transhiatal esophagectomy with a cervical anastomosis is an established procedure for the treatment of esophageal cancer. It is important to select the proper patients for this procedure, mostly avoiding those with severe mediastinal adhesions secondary to prior operations or radiotherapy, or those with T4 tumors. Cancer of the distal esophagus and esophago-gastric junction are well suited for this procedure, as most of the dissection of the area involved by the cancer can be done under direct vision.
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