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Ann Thorac Surg 1990;49:763-766
© 1990 The Society of Thoracic Surgeons

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Articles

Esophagogastrectomy via left thoracophrenotomy

Regional Adult Cardiothoracic Unit, Broadgreen Hospital, Liverpool, England

Accepted for publication December 26, 1989.

^_* Address reprint requests to Mr Donnelly, Broadgreen Hospital, Thomas Dr, Liverpool, England L14 3LB.

Eschagogastrectomy is generally considered to be the treatment of choice for resectable tumors of the esophagus. Although many approaches and techniques have been advocated, since April 1983 we have used a left thoracophrenotomy approach for most lesions of the lower two thirds of the esophagus and gastric cardia. Stapling instruments have been used for mobilization of the stomach and fashioning of the esophagogastric anastomosis. One-hundred fifteen patients undergoing resection of malignant tumors with this technique were retrospectively reviewed. Perioperative mortality was 8.7% ([equation]). The rate of anastomotic leakage was 1.7% ([equation]), and benign narrowing of the anastomosis requiring dilation developed in 16 patients. The rate of recurrent anastomotic tumor was 4.3%. Eighteen patients had complications, and the mean postoperative hospital stay was 13 days. Survival at 3 years was 22.1%. During the period of study, 22 patients underwent esophageal resection by some other approach; the reasons for this are described. The advantages of the left thoracophrenotomy approach are discussed.

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