Carcinoma : Left-Sided Approach for Resection of the Lower Oesophagus and Gastro-oesophageal Junction (Logan Operation)

Abstract

This extensive operation allows en bloc resection of the oesophagus and adjacent lymph nodes from the level of the carina, extending inferiorly to the coeliac axis. It is undertaken with curative intent and less ambitious resections should be used in patients clearly incurable. The proximal macroscopic extent of tumour as assessed endoscopically and on contrast X-rays must be beyond the lower margin of the aortic arch. At this level sufficient oesophagus can usually be devolved from beneath the aortic arch so as to permit an anastomosis below the aorta, but if additional length is required the oesophagus may be mobilised above the aorta and brought outwith the aortic arch.