Abdominal and right thoracic subtotal oesophagectomy

Abstract

Before 1946, the only widely practised approach to the thoracic oesophagus had been described by Sweet¹ using a left-sided thoracotomy. Although this operation permitted relatively good access to the lower third of the oesophagus, cancers of the middle and upper third of the oesophagus were dissected with greater difficulty because of the overlying aortic arch. In 1946 Lewis described the abdominal and right thoracic approach² for subtotal oesophagectomy. This operation was adopted by Tanner in the UK³ (Lewis—Tanner operation) and by Santy⁴ in France (Lewis—Santy operation), and has remained the favoured operation for an abdominal and right thoracic subtotal oesophagectomy.