Thoracic Esophagectomy for Lower Esophageal Cancer through Left Oblique Thoracolaparotomy and Right Posterolateral Thoracotomy

Abstract

Radical operations for lower esophageal cancer, including lymph node dissection in the upper, middle and lower mediastinal and the upper abdominal regions were performed through a left oblique thoracolaparotomy and a right posterolateral thoracotomy in 5 cases. A satisfactory surgical view through the oblique thoracolaparotomy insured easy, safe and complete removal of the tumor and the lymph nodes in the lower mediastinal and upper abdominal regions, and additional right posterolateral thoracotomy was useful for the lymph node dissection in the upper and middle mediastinum. Reconstruction was performed by the intrathoracic anastomosis between the upper esophagus and the gastric tube or jejunum using the EEA stapling device. Extubation of a tracheal tube was possible within 3 days after operation in all cases, and no respiratory complication was noted in any case. This new approach for lower esophageal cancer is considered to be useful for easy, safe and complete removal of the tumor and the regional lymph nodes.