Illustrations of Surgery for Carcinoma in the Thoracic Esophagus

Abstract

Since the establishment of the Japanese Society for Esophageal Diseases in 1965 and the publication of the Guidelines for Clinical and Pathologic Studies on Carcinoma of the Esophagus [1] in 1969, lymph node dissection during esophagectomy has gradually become accepted in Japan, though not so in the rest of the world, perhaps because of the complexity of the procedure. Since cervico-thoraco-abdominal lymph node dissection for carcinoma in the thoracic esophagus was first reported by Sannohe [2] in 1981, this procedure has been adopted as the standard approach. However, there remain many problems in nomenclature and topographical definition of the cervical and mediastinal lymph nodes in the Guidelines. Here, we describe in detail our standard procedure for cervico-thoraco-abdominal lymph node dissection, using the nomenclature and definitions set out by the International Society for Diseases of the Esophagus (ISDE) Research Committee [3].