We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
Published online by Cambridge University Press: 12 January 2010
Esophagogastrectomy is usually performed for high-grade dysplasia or carcinoma of the esophagus, particularly of the middle and lower thirds. Less common indications for this procedure are nondilatable stricture of the distal esophagus requiring resection and rupture of the esophagus that is irreparable.
Two separate incisions are generally used: abdominal and right thoracic. A left thoracotomy or left thoracoabdominal incision may be used for carcinoma of the distal esophagus and the gastroesophageal junction. A combined laparoscopic/thoracoscopic approach is currently undergoing clinical evaluation but is still considered experimental, while the open approach remains the gold standard. To mobilize the stomach, the short gastric, left gastroepiploic, and left gastric arteries are sacrificed, and the blood supply through the right gastroepiploic and right gastric arteries is preserved. The distal line of resection in the proximal stomach is securely closed and an esophagogastric anastomosis is performed on the anterior surface of the stomach below the line of resection. Feeding jejunostomy with pyloroplasty or pyloromyotomy may be done. Surgical stress is great and the procedure has relatively high morbidity and mortality rates. Anesthesia is endotracheal, using a double lumen tube to allow the lung on the side of the operation to remain collapsed. The procedure takes 4 to 6 hours and requires 2 to 4 units of blood.
Usual postoperative course
Expected postoperative hospital stay
Seven to 10 days.
Operative mortality
The operative mortality rate is approximately 4%–5%.
To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Find out more about the Kindle Personal Document Service.
To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.
To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.
