RT Book, Section
A1 Morse, Christopher R.
A1 Mathisen, Douglas J.
A2 Sugarbaker, David J.
A2 Bueno, Raphael
A2 Colson, Yolonda L.
A2 Jaklitsch, Michael T.
A2 Krasna, Mark J.
A2 Mentzer, Steven J.
A2 Williams, Marcia
A2 Adams, Ann
SR Print(0)
ID 1105839008
T1 Left Thoracoabdominal Approach
T2 Adult Chest Surgery, 2e
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-178189-3
LK accesssurgery.mhmedical.com/content.aspx?aid=1105839008
RD 2024/04/19
AB A  thoracoabdominal  approach  to  resection  of  the  esophagus  is  most  useful  with  tumors  of  the  distal  esophagus  that  lie  inferior  to  the  aortic  arch  as  well  as  lesions  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,  Sweet3  described  the  technique  of  anastomosis  on  the  basis  of  the  principles  of  meticulous  technique  and  attention  to  detail.  The  thoracoabdominal  incision  provides  excellent  access  to  the  abdomen.  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