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Abdominal—right thoracic approach to oesophagectomy

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Surgery of the Upper Gastrointestinal Tract

Abstract

The abdominal—right chest approach is the procedure of choice in the authors’ unit for patients with growths of the middle and lower third of the oesophagus. A right thoracotomy gives the best exposure for the extirpation of the oesophagus, and the mobilized isoperistaltic stomach is used to restore digestive tract continuity. After adequate mobilization, the fundus of the stomach can reach as high as the palate. Because of its rich blood supply the stomach is the most reliable organ for oesophageal substitution. It carries the lowest rate of necrosis and anastomotic leakage. Compared with colonic interposition, stomach pull-up is a much simpler operation as only one anastomosis is necessary.

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Further reading

  • Akiyama H, Miyazons H, Tsurumaru M, Hashimoto C, Kawamura T. Use of the stomach as an esophageal substitute. Ann Surg 1978; 188: 606–10.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Chung SCS, Griffin SM, Wood SDS, Crofts TJ, Li AKC. Two team synchronous esophagectomy. Surg Gynecol Obstet 1990; 170: 68–9.

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  • Wood SDS, McGuire LJ, Chung SCS, Crofts TJ, Li AKC. Intrathoracic stapled anastomosis after oesophagectomy for cancer. Aust NZ J Surg 1989; 59: 647–51.

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Author information

Authors and Affiliations

  1. Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China

    S. C. S. Chung MD, FRCS(Ed), MRCP (Reader in Surgery) & A. K. C. Li MA, MD, FRCS, FRCS(Ed), FRACS, FACS (Professor and Chairman)

Authors
  1. S. C. S. Chung MD, FRCS(Ed), MRCP
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  2. A. K. C. Li MA, MD, FRCS, FRCS(Ed), FRACS, FACS
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Editor information

Editors and Affiliations

  1. Department of Surgery, Royal Adelaide Hospital, University of Adelaide, 5000, Adelaide, South Australia, Australia

    Glyn G. Jamieson FRACS, FACS (Dorothy Mortlock Professor of Surgery) (Dorothy Mortlock Professor of Surgery)

  2. University of California, 513 Parnassus Avenue, S-320, 94143-0104, San Francisco, California, USA

    Haile T. Debas MD (M. Galante Distinguished Professor of Surgery and Dean of the School of Medicine) (M. Galante Distinguished Professor of Surgery and Dean of the School of Medicine)

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© 1994 Springer Science+Business Media Dordrecht

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Chung, S.C.S., Li, A.K.C. (1994). Abdominal—right thoracic approach to oesophagectomy. In: Jamieson, G.G., Debas, H.T. (eds) Surgery of the Upper Gastrointestinal Tract. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-6621-6_7

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  • DOI: https://doi.org/10.1007/978-1-4899-6621-6_7

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-0-412-53550-5

  • Online ISBN: 978-1-4899-6621-6

  • eBook Packages: Springer Book Archive

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