RT Book, Section A1 Ellison, E. Christopher A1 Zollinger, Robert M. SR Print(0) ID 1127272371 T1 ESOPHAGECTOMY, TRANSTHORACIC T2 Zollinger's Atlas of Surgical Operations, 10e YR 2016 FD 2016 PB McGraw-Hill Education PP New York, NY SN 978-0-07-179755-9 LK accesssurgery.mhmedical.com/content.aspx?aid=1127272371 RD 2024/03/29 AB Transthoracic esophagectomy is indicated for the management of surgically resectable cancers of the esophagus and gastroesophageal junction. An abdominal incision is utilized to mobilize the distal esophagus and gastroesophageal junction, including the tumor and surrounding lymph nodes. The gastric conduit is mobilized and the blood supply is based on the right gastroepiploic artery. The thoracic esophagus is then approached through a right posterolateral thoracotomy through which the specimen is resected and reconstruction is performed. Surgical resection is indicated for early staged, nonmetastatic tumors that are not amenable to endoscopic resection (T1). Surgery is also performed for nonmetastatic, intermediate staged tumors (T2–T4, N1), but usually follows a course of chemoradiation and restaging. Transthoracic esophagectomy may also be indicated for the management of benign disease such as refractory strictures, caustic injuries, or a dilated “burned esophagus” with dysphagia following treatment for achalasia.