Transhiatal Esophagectomy for Esophageal Carcinoma
In almost every reported major series of esophageal resection for carcinoma, pulmonary complications following a combined thoracoabdominal procedure and sepsis from disruption of an intrathoracic esophageal anastomosis are the leading causes of postoperative complications and death. Although some recently reported exceptional series indicate a hospital mortality for esophageal resection of less than 5% [1–3], in most reports mortality ranges from 15% to 40% [4–6] and averages 33% . Transhiatal esophagectomy without thoracotomy and esophageal reconstruction with a cervical esophagogastric anastomosis offer several advantages over the standard transthoracic approach. The operation not only minimizes the physiologic insult to the patient by avoiding a thoracotomy, but it also places the anastomosis in the neck where the consequences of disruption are seldom serious. This operation has therefore become the author’s operation of choice in patients requiring esophageal resection for both benign and malignant disease [8–12].
KeywordsAdenocarcinoma Pneumonia Tempo Noma Mediastinitis
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