Cervical anastomosis by thoracic approach for the treatment of upper esophageal cancer

Abstract

Cervical anastomosis by the thoracic approach for the treatment of upper esophageal cancer can simplify surgical steps and reduce incidence of anastomotic leak. This approach has been used for 26 patients with upper esophageal cancer who were admitted to the Jiangsu Cancer Hospital from July 2006 to August 2009. The mean length between lesion and incisor was 23.3 cm. General anesthesia and double-lumen intubation through left posterolateral incision the fifth intercostal space was adopted. The stomach was dissociated with the technique of in situ dissociation, and esophagus was dissociated conventionally. Double purse-string suture was adopted to fix the esophageal mucosa onto the supportive base of the stapler, and make purse-string suture to fix stomach on the center pole of the stapler. There was one failure case which has been converted to the manual cervical anastomosis, and the operations for the rest 25 cases were completed successfully, without anastomotic leakage and positive margin. The average blood loss was (352 ±211 )ml, and the average operation time was (3.7 ±0.6 )hours. Key words: Esophageal neoplasms; Thoracic approach; Cervical anastomosis