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Surgical Anatomy of the Esophagus and Esophagogastric Junction

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Adenocarcinoma of the Esophagogastric Junction

Abstract

The esophagus is a flattened muscular tube, which is about 22 cm in length. It connects the pharynx to the stomach, extending from the level of the sixth cervical to the 11th thoracic vertebra. It has two high-pressure zones called upper esophageal sphincter (UES) and lower esophageal sphincter (LES), which prevent reflux from the esophagus into the pharynx and from the stomach to the esophagus, respectively. Spanning three anatomic regions, the esophagus is topographically divided into cervical, thoracic, and abdominal parts, which has unique features and relations with surrounding structures. Although essentially a midline structure, the esophagus deviates slightly to the left in the neck, to the right in the thorax, and curves to the left again as it passes through the hiatus in the diaphragm.

The esophagus joins the stomach at the esophagogastric junction (EGJ). Although, the term “esophagogastric junction” implies a transition from the esophagus to the stomach, controversy exists about its precise location, and the EGJ indicates a complex of structures which may be defined differently by the surgeon, the anatomist, the radiologist, and the endoscopist.

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References

  1. Oezcelik A, DeMeester SR (2011) General anatomy of the esophagus. Thorac Surg Clin 21:289–297

    Article  PubMed  Google Scholar 

  2. Long JD, Orlando RC (2002) Anatomy, histology, embryology, and developmental abnormalities of the esophagus. In: Feldman M, Fieldman LS, Sleisenger MH (eds) Gastrointestinal and liver diseases. WB Saunders, Philadelphia, pp 551–560

    Google Scholar 

  3. Gavaghan M (1999) Anatomy and physiology of the esophagus. AORN J 69:372–386

    Article  CAS  PubMed  Google Scholar 

  4. Broering DC, Walter J, Halata Z (2009) Surgical anatomy of the esophagus. In: Izbicki JR, Broering DC, Yekebas EF, Kutup A, Chernousov AF, Gallinger YI, Bogopolski PM, Söehendra N (eds) Surgery of the esophagus. Textbook and atlas of surgical practice. Springer, Berlin/Heidelberg, pp 3–10

    Google Scholar 

  5. Patti MG, Gantert W, Way LW (1997) Surgery of the esophagus. Anatomy and physiology. Surg Clin North Am 77:959–970

    Article  CAS  PubMed  Google Scholar 

  6. Riddell AM, Davies DC, Allum WH, Wotherspoon AC, Richardson C, Brown G (2007) High-resolution MRI in evaluation of the surgical anatomy of the esophagus and posterior mediastinum. AJR Am J Roentgenol 188:W37–W43

    Article  CAS  PubMed  Google Scholar 

  7. Huang Q (2011) Definition of the esophagogastric junction: a critical mini review. Arch Pathol Lab Med 135:384–3898

    PubMed  Google Scholar 

  8. Mittal RK, Balaban DH (1997) The esophagogastric junction. N Engl J Med 336:924–932

    Article  CAS  PubMed  Google Scholar 

  9. Hayward J (1961) The lower end of the esophagus. Thorax 16:36–41

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Takubo K, Aida J, Sawabe M, Arai T, Kato H, Pech O, Arima M (2008) The normal anatomy around the esophagogastric junction: a histopathologic view and correlation with endoscopy. Best Pract Res Clin Gastroenterol 22:569–5483

    Article  PubMed  Google Scholar 

  11. Kumoi K, Ohtsuki N, Teramoto Y (2001) Pharyngoesophageal diverticulum arising from Laimer’s triangle. Eur Arch Otorhinolaryngol 258:184–187

    Article  CAS  PubMed  Google Scholar 

  12. Rubesin SE, Levine MS (2001) Killian-Jamieson diverticula: radiographic findings in 16 patients. AJR Am J Roentgenol 177:85–89

    Article  CAS  PubMed  Google Scholar 

  13. Sivarao DV, Goyal RK (2000) Functional anatomy and physiology of the upper esophageal sphincter. Am J Med 108(Suppl 4a):27S–37S

    Article  PubMed  Google Scholar 

  14. Preiksaitis HG, Diamant NE (1997) Regional differences in cholinergic activity of muscle fibers from the human gastroesophageal junction. Am J Physiol 272(6 Pt 1):G1321–G1327

    CAS  PubMed  Google Scholar 

  15. Skandalakis JE, Ellis H (2000) Embryologic and anatomic basis of esophageal surgery. Surg Clin North Am 80:85–155

    Article  CAS  PubMed  Google Scholar 

  16. Bombeck CT, Dillard DH, Nyhus LM (1966) Muscular anatomy of the gastroesophageal junction and role of phrenoesophageal ligament; autopsy study of sphincter mechanism. Ann Surg 164:643–654

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Eliska O (1973) Phrenoesophageal membrane and its role in the development of hiatal hernia. Acta Anat (Basel) 86:137–150

    Article  CAS  Google Scholar 

  18. Friedland GW (1978) Progress in radiology: historical review of the changing concepts of lower esophageal anatomy: 430 B.C.--1977. Am J Roentgenol 131:373–378

    Article  CAS  Google Scholar 

  19. Miura T, Grillo HC (1966) The contribution of the inferior thyroid artery to the blood supply of the human trachea. Surg Gynecol Obstet 123:99–102

    CAS  PubMed  Google Scholar 

  20. Williams DB, Payne WS (1982) Observations on esophageal blood supply. Mayo Clin Proc 57:448–453

    CAS  PubMed  Google Scholar 

  21. Liebermann-Meffert D, Siewert JR (1992) Arterial anatomy of the esophagus. A review of literature with brief comments on clinical aspects. Gullet 2:3–10

    Google Scholar 

  22. Yan Y, Chen C, Chen Y, Wu Y, Shi Z (1998) Arterial patterns in the thoracic and abdominal segments of the esophagus: anatomy and clinical significance. Surg Radiol Anat 20:399–402

    Article  CAS  PubMed  Google Scholar 

  23. Liebermann-Meffert D, Lüscher U, Neff U, Rüedi TP, Allgöwer M (1987) Esophagectomy without thoracotomy: is there a risk of intramediastinal bleeding? A study on blood supply of the esophagus. Ann Surg 206:184–192

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Orringer MB, Orringer JS (1983) Esophagectomy without thoracotomy: a dangerous operation? J Thorac Cardiovasc Surg 85:72–80

    CAS  PubMed  Google Scholar 

  25. Phang K, Bowman M, Phillips A, Windsor J (2014) Review of thoracic duct anatomical variations and clinical implications. Clin Anat 27:637–644

    Article  CAS  PubMed  Google Scholar 

  26. Cunningham ET, Sawcenko PE (1990) Central neural control of esophageal motility: a review. Dysphagia 5:35–51

    Article  CAS  PubMed  Google Scholar 

  27. Cernea CR, Ferraz AR, Nishio S, Dutra A Jr, Hojaij FC, dos Santos LR (1992) Surgical anatomy of the external branch of the superior laryngeal nerve. Head Neck 14:380–383

    Article  CAS  PubMed  Google Scholar 

  28. Haller JM, Iwanik M, Shen FH (2012) Clinically relevant anatomy of recurrent laryngeal nerve. Spine (Phila Pa 1976) 37:97–100

    Article  Google Scholar 

  29. Skandalakis JE, Droulias C, Harlaftis N, Tzinas S, Gray SW, Akin JT (1976) The recurrent laryngeal nerve. Am Surg 42:629–634

    CAS  PubMed  Google Scholar 

  30. Liebermann-Meffert D, Walbrun B, Hiebert CA, Siewert JR (1999) Recurrent and superior laryngeal nerves: a new look with implications for the esophageal surgeon. Ann Thorac Surg 67:217–223

    Article  CAS  PubMed  Google Scholar 

  31. Henry JF, Audiffret J, Denizot A, Plan M (1988) The nonrecurrent inferior laryngeal nerve: review of 33 cases, including two on the left side. Surgery 104:977–984

    CAS  PubMed  Google Scholar 

  32. Galletta G, Cesario A, Margaritora S, Granone P (2008) Anomalous intrathoracic left vagus and recurrent laryngeal nerve course. Ann Thorac Surg 86:654–655

    Article  Google Scholar 

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Correspondence to Alberto Di Leo .

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Di Leo, A., Zanoni, A., Giacopuzzi, S., Ricci, F., de Manzoni, G. (2017). Surgical Anatomy of the Esophagus and Esophagogastric Junction. In: Giacopuzzi, S., Zanoni, A., de Manzoni, G. (eds) Adenocarcinoma of the Esophagogastric Junction. Springer, Cham. https://doi.org/10.1007/978-3-319-28776-8_25

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  • DOI: https://doi.org/10.1007/978-3-319-28776-8_25

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  • Online ISBN: 978-3-319-28776-8

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