ABSTRACT
More than 100 years ago, esophagectomy began to be used for obstructive esophageal diseases. This operation provides a means for resecting the thoracic esophagus, with anastomosis of the esophagus to the fundus of the stomach in the thorax or in the neck from the left side. The principal indication for this approach is resection of tumors of the thoracic esophagus and cardia, but it is also applicable to resection of a benign esophageal stricture. Since the predominant symptom of esophageal carcinoma is difficulty in swallowing, most patients are nutritionally depleted. The nutritional status of the patients is important in predicting the outcome. In addition to the effects of thoracotomy on pulmonary function, the intrathoracic stomach takes up room in the thorax after esophagectomy, and this adversely affects pulmonary function. For resection of the gastric cardia, the dissection of the esophagus needs to be carried out to the level of the inferior pulmonary vein.
