Esophagectomy Without Thoracotomy Using the Cervicoabdominal Approach for the Management of Esophageal Carcinoma: Results
Obstructive diseases, especially neoplasms of the esophagus, frequently cause serious nutritional disturbances, besides the associated pulmonary changes due to aspiration of stagnant esophageal content. In addition, neoplasms occur in an older age group with a higher incidence of chronic obstructive pulmonary disease. Therefore, in these patients, there is a higher risk of postoperative pulmonary complications when performing esophagectomy via thoracotomy. Pain from thoracotomy also contributes, resulting in decreased ventilation and accumulation of secretions and pleural effusions; also the patient’s lateral position during the operation causes hypoventilation of the contralateral lung and passage of secretions from the compressed lung to the other. In order to eliminate these drawbacks, we remove the esophagus via a cervicoabdominal approach without thoracotomy . This approach also allows the surgical staging of the neoplasm, with visualization of the lymph nodes of the lesser curvature, celiac trunk, and the hepatic parenchyma, and it provides better assessment of resectability without the need for thoracotomy.
KeywordsChronic Obstructive Pulmonary Disease Esophageal Cancer Celiac Trunk Surgical Staging Cervical Esophagus
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