ABSTRACT

The two most frequently performed operations for esophageal resection are transthoracic esophagectomy and blunt transhiatal esophagectomy. The transthoracic approach allows the surgeon to mobilize the thoracic esophagus under direct visualization and perform a wide mediastinal lymphadenectomy, which often cannot be performed by a transhiatal approach. In contrast, the transhiatal approach avoids a thoracotomy and therefore possibly reduces associated pulmonary complications. Both techniques, however, can be associated with significant morbidity and mortality.