Ivor Lewis Esophagectomy

  • Nassrene Y. Elmadhun
  • Manjit S. BainsEmail author


Ivor Lewis esophagectomy remains a durable procedure for the resection of mid to distal esophageal carcinoma. This chapter discusses the indications and contraindications for Ivor Lewis esophagectomy and details a step by step guide for open Ivor Lewis esophagectomy operative technique as well as management strategies for common complications.


Esophageal cancer Open esophagectomy Ivor Lewis esophagectomy Transthoracic esophagectomy Anastomosis 


  1. 1.
    Dubecz A, Schwartz SI. Franz John A. Torek. Ann Thorac Surg. 2008;85(4):1497–9.CrossRefPubMedGoogle Scholar
  2. 2.
    Churchill ED, Sweet RH. Transthoracic resection of tumors of the esophagus and stomach. Ann Surg. 1942;115(6):897–920.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Sweet RH. The treatment of carcinoma of the esophagus and cardiac end of the stomach by surgical extirpation; 203 cases of resection. Surgery. 1948;23(6):952–75.PubMedGoogle Scholar
  4. 4.
    Lewis I. The surgical treatment of carcinoma of the oesophagus; with special reference to a new operation for growths of the middle third. Br J Surg. 1946;34:18–31.CrossRefPubMedGoogle Scholar
  5. 5.
    Urschel JD, Blewett CJ, Young JE, Miller JD, Bennett WF. Pyloric drainage (pyloroplasty) or no drainage in gastric reconstruction after esophagectomy: a meta-analysis of randomized controlled trials. Dig Surg. 2002;19(3):160–4.CrossRefPubMedGoogle Scholar
  6. 6.
    Gaur P, Swanson SJ. Should we continue to drain the pylorus in patients undergoing an esophagectomy? Dis Esophagus. 2014;27(6):568–73.CrossRefPubMedGoogle Scholar
  7. 7.
    Kim RH, Takabe K. Methods of esophagogastric anastomoses following esophagectomy for cancer: a systematic review. J Surg Oncol. 2010;101(6):527–33.CrossRefPubMedGoogle Scholar
  8. 8.
    Law S, Fok M, Chu KM, Wong J. Comparison of hand-sewn and stapled esophagogastric anastomosis after esophageal resection for cancer: a prospective randomized controlled trial. Ann Surg. 1997;226(2):169–73.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Beitler AL, Urschel JD. Comparison of stapled and hand-sewn esophagogastric anastomoses. Am J Surg. 1998;175(4):337–40.CrossRefPubMedGoogle Scholar
  10. 10.
    Honda M, Kuriyama A, Noma H, Nunobe S, Furukawa TA. Hand-sewn versus mechanical esophagogastric anastomosis after esophagectomy: a systematic review and meta-analysis. Ann Surg. 2013;257(2):238–48.CrossRefPubMedGoogle Scholar
  11. 11.
    Mathisen DJ, Grillo HC, Wilkins EW Jr, Moncure AC, Hilgenberg AD. Transthoracic esophagectomy: a safe approach to carcinoma of the esophagus. Ann Thorac Surg. 1988;45(2):137–43.CrossRefPubMedGoogle Scholar
  12. 12.
    Ellis FH Jr, Heatley GJ, Krasna MJ, Williamson WA, Balogh K. Esophagogastrectomy for carcinoma of the esophagus and cardia: a comparison of findings and results after standard resection in three consecutive eight-year intervals with improved staging criteria. J Thorac Cardiovasc Surg. 1997;113(5):836–46. discussion 46–8.CrossRefPubMedGoogle Scholar
  13. 13.
    Visbal AL, Allen MS, Miller DL, Deschamps C, Trastek VF, Pairolero PC. Ivor Lewis esophagogastrectomy for esophageal cancer. Ann Thorac Surg. 2001;71(6):1803–8.CrossRefPubMedGoogle Scholar
  14. 14.
    Griffin SM, Shaw IH, Dresner SM. Early complications after Ivor Lewis subtotal esophagectomy with two-field lymphadenectomy: risk factors and management. J Am Coll Surg. 2002;194(3):285–97.CrossRefPubMedGoogle Scholar
  15. 15.
    Dasari BV, Neely D, Kennedy A, Spence G, Rice P, Mackle E, et al. The role of esophageal stents in the management of esophageal anastomotic leaks and benign esophageal perforations. Ann Surg. 2014;259(5):852–60.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Salminen P, Gullichsen R, Laine S. Use of self-expandable metal stents for the treatment of esophageal perforations and anastomotic leaks. Surg Endosc. 2009;23(7):1526–30.CrossRefPubMedGoogle Scholar
  17. 17.
    Cassivi SD. Leaks, strictures, and necrosis: a review of anastomotic complications following esophagectomy. Semin Thorac Cardiovasc Surg. 2004;16(2):124–32.CrossRefPubMedGoogle Scholar
  18. 18.
    Park JY, Song HY, Kim JH, Park JH, Na HK, Kim YH, et al. Benign anastomotic strictures after esophagectomy: long-term effectiveness of balloon dilation and factors affecting recurrence in 155 patients. AJR Am J Roentgenol. 2012;198(5):1208–13.CrossRefPubMedGoogle Scholar
  19. 19.
    Kim HC, Shin JH, Song HY, Park SI, Ko GY, Youn HK, et al. Fluoroscopically guided balloon dilation for benign anastomotic stricture after Ivor-Lewis esophagectomy: experience in 62 patients. J Vasc Interv Radiol. 2005;16(12):1699–704.CrossRefPubMedGoogle Scholar
  20. 20.
    Mishra PK, Saluja SS, Ramaswamy D, Bains SS, Haque PD. Thoracic duct injury following esophagectomy in carcinoma of the esophagus: ligation by the abdominal approach. World J Surg. 2013;37(1):141–6.CrossRefPubMedGoogle Scholar
  21. 21.
    Wormuth JK, Heitmiller RF. Esophageal conduit necrosis. Thorac Surg Clin. 2006;16(1):11–22.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Thoracic Surgery Service, Department of SurgeryMemorial Sloan Kettering Cancer CenterNew YorkUSA

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