Adenocarcinoma of the Distal Esophagus and Gastric Cardia: Comparison of Results of Transhiatal Esophagectomy and Thoracoabdominal Esophagogastrectomy

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Abstract
The traditional surgical approach to adenocarcinoma of the distal esophagus and cardia is thoracoabdominal esophagogastrectomy (EG) with resection of nearly half of the proximal stomach and intrathoracic esophagogastric anastomosis. During the past 10 years, however, transhiatal esophagectomy without thoracotomy (THE), has become our preferred operative approach in nearly all patients requiring esophagectomy for both benign and malignant disease, including those with adenocarcinoma of the distal esophagus and cardia [1–5]. It has been our clinical impression that this method provides a physiologically less stressful operation for these patients, has several additional important advantages, and results in survival as good as that obtained by the more conventional EG. This study is a retrospective review of the cumulative experience of the University of Michigan over the past 20 years with surgery for adenocarcinoma of the distal esophagus or cardia and permits a comparison of patients who underwent either standard EG or THE with partial proximal gastrectomy. Keywords Anastomotic Leakage Distal Esophagus Gastric Cardia Gastric Outlet Obstruction Transhiatal Esophagectomy These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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