K. Omura et al., LARYNX-PRESERVING RESECTION OF THE CERVICAL ESOPHAGUS FOR CERVICAL ESOPHAGEAL-CARCINOMA LIMITED TO THE SUBMUCOSAL LAYER, Journal of surgical oncology, 69(2), 1998, pp. 113-116
This report describes the surgical procedure consisting of larynx-pres
erving resection of the cervical esophagus and satisfactory lymphadene
ctomy. The sternum was split at the level of the 3rd intercostal space
, which allowed an upper-mediastinal lymphadenectomy to be performed e
asily. The cervical esophagus was reconstructed using a free jejunal a
utograft. The stump of the thoracic esophagus and the caudad stump of
the jejunal graft were anastomosed using a circular stapling instrumen
t. The posterior part of the cephalad esophagojejunostomy was complete
d in two layers using the Lembert stitch. The wall of the cervical eso
phagus was opened to determine the oral cut line considering the safet
y margin from the carcinoma. After cervical esophagectomy was complete
d, suturing of the anterior wall was performed in one layer. The left
cervical transverse artery and the internal jugular vein were employed
for recipient vessels. This procedure is acceptable for high cervical
esophageal carcinoma Limited to the submucosal layer. (C) 1998 Wiley-
Liss, Inc.