Abstract
There are two important Minimally Invasive Esophagectomy approaches, the three-stage McKeown procedure with cervical anastomosis and the two-stage Ivor Lewis procedure with intrathoracic anastomosis. To perform these procedures, a profound knowledge of the surgical anatomy of the mediastinum and esophagus is paramount. Subcarinal anatomy of esophagus is in many aspects different from the supracarinal anatomy with important implications for the dissection of distal esophageal and Gastroesophageal Junction tumors. In this chapter the subcarinal anatomy is depicted.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Heald RJ, Ryall RDH. Recurrence and survival after total mesorectal excision for rectal cancer. Lancet. 1986;1:1479–82.
Kluth D, Fiegel H. The embryology of the foregut. Semin Pediatr Surg. 2003;12:3–9.
Brugger PC, Weber M, Prayer D. Magnetic resonance imaging of the normal fetal esophagus. Ultrasound Obstet Gynecol. 2011;38:568–74.
Metzger R, Wachowiak R, Kluth D. Embryology of the early foregut. Semin Pediatr Surg. 2011;20:136–44.
Cuesta MA, Weijs TJ, Bleys RL et al. A new concept of the anatomy of the thoracic oesophagus: the meso-oesophagus. Observational study during thoracoscopic oesophagectomy. Surg Endosc. 2015;29:2576–82.
Cuesta MA, van der Wielen N, Weijs TJ et al. Surgical anatomy of the supracarinal esophagus based on a minimally invasive approach: vascular and nervous anatomy and technical steps to resection and lymphadenectomy. Surg Endosc. 2017;31:1863–1870.
Fujiwara H, Kanamori J, Nakajima Y, Kawano T et al. An anatomical hypothesis: a “concentricstructured model” for the theoretical understanding of the surgical anatomy in the upper mediastinum required for esophagectomy with radical mediastinal lymph node dissection. Dis Esophagus. 2019 Aug 1;32(8):doy119. https://doi.org/10.1093/dote/doy119.
Matsubara T, et al. Cervicothoracic approach for total mesoesophageal dissection in cancer of the thoracic esophagus. J Am Coll Surg. 1998;187:238–45.
Marchand P. The anatomy and applied anatomy of the mediastinal fascia. Thorax. 1951;6:359–68.
Riddell AM, et al. High-resolution MRI in evaluation of the surgical anatomy of the esophagus and posterior mediastinum. Am J Roentgenol. 2007;188:37–43.
Izon AS, Jose P, Hayden JD, Grabsch HI. Significant variation of resected meso-esophageal tissue volume in two-stage subtotal esophagectomy specimen: a retrospective morphometric study. Ann Surg Oncol. 2013;20:788–97.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
3.1 Electronic supplementary material
Below is the link to the electronic supplementary material.
Minimally invasive surgical dissection of the esophagus by thoracoscopy in prone position permits us to observe “live” with magnification of the anatomy as it really is
Rights and permissions
Copyright information
© 2021 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Cuesta, M.A. (2021). A Surgical Concept for the Subcarinal Anatomy of the Esophagus and Mediastinum. In: Asunción Acosta, M., Cuesta, M.A., Bruna, M. (eds) Atlas of Minimally Invasive Techniques in Upper Gastrointestinal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-55176-6_3
Download citation
DOI: https://doi.org/10.1007/978-3-030-55176-6_3
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-55175-9
Online ISBN: 978-3-030-55176-6
eBook Packages: MedicineMedicine (R0)