RT Book, Section
A1 Coe, Taylor M.
A1 Morse, Christopher R.
A1 Mathisen, Douglas J.
A2 Sugarbaker, David J.
A2 Bueno, Raphael
A2 Burt, Bryan M.
A2 Groth, Shawn S.
A2 Loor, Gabriel
A2 Wolf, Andrea S.
A2 Williams, Marcia
A2 Adams, Ann
SR Print(0)
ID 1170406578
T1 Left Thoracoabdominal Approach
T2 Sugarbaker’s Adult Chest Surgery, 3e
YR 2020
FD 2020
PB McGraw-Hill Education
PP New York, NY
SN 9781260026931
LK accesssurgery.mhmedical.com/content.aspx?aid=1170406578
RD 2024/04/25
AB A  thoracoabdominal  approach  to  resection  of  the  esophagus  is  most  useful  for  tumors  of  the  distal  esophagus  that  lie  inferior  to  the  aortic  arch  and  tumors  of  the  gastric  cardia.  Eggers  first  reported  the  use  of  a  left  thoracoabdominal  incision  for  a  partial  resection  of  the  esophagus  in  1931.1  Eventual  resection  of  the  distal  esophagus  and  replacement  with  mobilized  stomach  was  described  by  Adams  and  Phemister  in  1938.2  Finally,  Sweet  described  the  technique  of  anastomosis  based  on  the  principles  of  meticulous  technique  and  attention  to  detail.3  The  thoracoabdominal  incision  provides  excellent  access  to  the  abdomen,  and  with  extension  of  the  incision  through  the  costal  arch,  left  rectus  muscle,  and  diaphragm,  the  esophagus  can  be  mobilized  and  replaced  with  stomach,  colon,  or  jejunum  depending  on  the  situation.  In  addition,  with  an  upward  paravertebral  extension  of  the  incision  and  Sweet’s  double-rib  resection,  one  can  reach  almost  any  lesion  of  the  intrathoracic  esophagus.3