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Surgical management of resectable esophageal and esophagogastric junction cancers

Scott Swanson, MD
Section Editor
Kenneth K Tanabe, MD
Deputy Editors
Wenliang Chen, MD, PhD
Diane MF Savarese, MD


Esophageal cancer presents as localized disease, defined as adenocarcinoma or squamous cell carcinoma confined to the esophagus, in approximately 22 percent of all cases [1]. Regional disease, which includes spread to regional lymph nodes, accounts for another 30 percent of patients with esophageal cancer. The goal of surgical management is curative, and a surgical resection is the traditional mainstay of multidisciplinary therapy for patients with localized disease [2-5]. The clinical spectrum of esophageal cancer has changed over the last few decades, with an increase in incidence of adenocarcinoma and a decrease of squamous cell carcinoma [6-11]. Surgical management is independent of histology.

The selection criteria and surgical management of patients with esophageal cancer are discussed in this topic. Neoadjuvant and adjuvant chemotherapy and radiation therapy, and management of patients with unresectable esophageal cancer are reviewed separately. (See "Radiation therapy, chemoradiotherapy, neoadjuvant approaches, and postoperative adjuvant therapy for localized cancers of the esophagus" and "Management of locally advanced unresectable and inoperable esophageal cancer".)


The esophagus, which is approximately 25 to 30 cm in length, is located in the posterior mediastinum and extends from the level of the 7th cervical vertebra to the 11th thoracic vertebra (figure 1 and figure 2 and figure 3). It is divided into four anatomic areas including cervical, thoracic, lower thoracic/esophagogastric junction, and the abdominal esophagus (figure 4 and figure 5 and figure 6). The esophagus is composed of the mucosa, submucosa, muscularis externa, and adventitia (image 1). There are three critical anatomic points of narrowing: the cricopharyngeus muscle, the broncho-aortic constriction, and the esophagogastric junction, which are also the most common sites of iatrogenic and mechanical perforation (figure 7 and figure 8) [12].

The arterial supply includes the inferior thyroid artery (cervical esophagus), bronchial arteries and the aorta (thoracic esophagus), and branches of the left gastric artery and inferior phrenic artery (abdominal esophagus) (figure 9). The venous drainage is through the inferior thyroid vein (cervical esophagus); the azygous vein, the hemiazygous vein, or the bronchial veins (thoracic esophagus); and the coronary vein (abdominal esophagus) (figure 10).

The esophagus has a rich network of lymphatic channels in the submucosa that can facilitate the longitudinal spread of neoplastic cells along the esophageal wall. Lymphatic drainage is to cervical nodes, tracheobronchial and mediastinal nodes, and gastric and celiac nodes (figure 11). An important point is that the regional lymph nodes for all locations in the esophagus, including the cervical esophagus and esophagogastric junction, extend from the periesophageal cervical nodes to celiac nodes (figure 12) [13].

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Literature review current through: Sep 2017. | This topic last updated: Mar 15, 2017.
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  1. SEER Stat Fact Sheets: Esophagus; Survival and Stage. seer.cancer.gov/statfacts/html/esoph.html#survival (Accessed on May 01, 2012).
  2. D'Amico TA. Outcomes after surgery for esophageal cancer. Gastrointest Cancer Res 2007; 1:188.
  3. Hirst J, Smithers BM, Gotley DC, et al. Defining cure for esophageal cancer: analysis of actual 5-year survivors following esophagectomy. Ann Surg Oncol 2011; 18:1766.
  4. Miyata H, Yamasaki M, Kurokawa Y, et al. Multimodal treatment for resectable esophageal cancer. Gen Thorac Cardiovasc Surg 2011; 59:461.
  5. Ajani J, D'Amico TA, Hayman JA, et al. Esophageal cancer. Clinical practice guidelines in oncology. J Natl Compr Canc Netw 2003; 1:14.
  6. Blot WJ, McLaughlin JK. The changing epidemiology of esophageal cancer. Semin Oncol 1999; 26:2.
  7. Roth JA. Treatment of esophageal cancer: does surgery make the cut? Gastrointest Cancer Res 2007; 1:207.
  8. Markar SR, Karthikesalingam A, Thrumurthy S, Low DE. Volume-outcome relationship in surgery for esophageal malignancy: systematic review and meta-analysis 2000-2011. J Gastrointest Surg 2012; 16:1055.
  9. McNamara MJ, Adelstein DJ. Current developments in the management of locally advanced esophageal cancer. Curr Oncol Rep 2012; 14:342.
  10. Narsule CK, Montgomery MM, Fernando HC. Evidence-based review of the management of cancers of the gastroesophageal junction. Thorac Surg Clin 2012; 22:109.
  11. Devesa SS, Blot WJ, Fraumeni JF Jr. Changing patterns in the incidence of esophageal and gastric carcinoma in the United States. Cancer 1998; 83:2049.
  12. Cooke DT, Lau CL. Primary repair of esophageal perforation. Operative Techniques in Thoracic and Cardiovascular Surgery 2008; 13:126.
  13. Rice TW, Kelsen D, Blackstone EH, et al.. Esophagus and esophagogastric junction.. In: AJCC Cancer Staging Manual, 8th, Amin MB. (Ed), AJCC, Chicago 2017. p.185.
  14. American Joint Committee on Cancer Staging Manual, 7th, Edge S, Byrd, DR, Compton, CC, et al (Eds), Springer, New York 2010.
  15. Rüdiger Siewert J, Feith M, Werner M, Stein HJ. Adenocarcinoma of the esophagogastric junction: results of surgical therapy based on anatomical/topographic classification in 1,002 consecutive patients. Ann Surg 2000; 232:353.
  16. Ajani JA, In H, Sano T, et al.. Stomach.. In: AJCC Cancer Staging Manual, 8th, Amin MB.. (Ed), AJCC, Chicago 2017. p.203.
  17. Wu AJ, Goodman KA. Clinical tools to predict outcomes in patients with esophageal cancer treated with definitive chemoradiation: are we there yet? J Gastrointest Oncol 2015; 6:53.
  18. Lin SH, Wang J, Allen PK, et al. A nomogram that predicts pathologic complete response to neoadjuvant chemoradiation also predicts survival outcomes after definitive chemoradiation for esophageal cancer. J Gastrointest Oncol 2015; 6:45.
  19. Kumagai K, Rouvelas I, Tsai JA, et al. Meta-analysis of postoperative morbidity and perioperative mortality in patients receiving neoadjuvant chemotherapy or chemoradiotherapy for resectable oesophageal and gastro-oesophageal junctional cancers. Br J Surg 2014; 101:321.
  20. Miao L, Chen H, Xiang J, Zhang Y. A high body mass index in esophageal cancer patients is not associated with adverse outcomes following esophagectomy. J Cancer Res Clin Oncol 2015; 141:941.
  21. Inoue J, Ono R, Makiura D, et al. Prevention of postoperative pulmonary complications through intensive preoperative respiratory rehabilitation in patients with esophageal cancer. Dis Esophagus 2013; 26:68.
  22. Affleck DG, Karwande SV, Bull DA, et al. Functional outcome and survival after pharyngolaryngoesophagectomy for cancer. Am J Surg 2000; 180:546.
  23. Triboulet JP, Mariette C, Chevalier D, Amrouni H. Surgical management of carcinoma of the hypopharynx and cervical esophagus: analysis of 209 cases. Arch Surg 2001; 136:1164.
  24. Wang HW, Chu PY, Kuo KT, et al. A reappraisal of surgical management for squamous cell carcinoma in the pharyngoesophageal junction. J Surg Oncol 2006; 93:468.
  25. Peracchia A, Bonavina L, Botturi M, et al. Current status of surgery for carcinoma of the hypopharynx and cervical esophagus. Dis Esophagus 2001; 14:95.
  26. Saito R, Suzuki H, Motoyama S, et al. A clinical study of surgical treatment of patients with carcinoma of the cervical esophagus extending to the thoracic esophagus. Jpn J Thorac Cardiovasc Surg 2000; 48:417.
  27. Amatsu M, Mohri M, Kinishi M. Significance of retropharyngeal node dissection at radical surgery for carcinoma of the hypopharynx and cervical esophagus. Laryngoscope 2001; 111:1099.
  28. Kelley DJ, Wolf R, Shaha AR, et al. Impact of clinicopathologic parameters on patient survival in carcinoma of the cervical esophagus. Am J Surg 1995; 170:427.
  29. Daiko H, Hayashi R, Saikawa M, et al. Surgical management of carcinoma of the cervical esophagus. J Surg Oncol 2007; 96:166.
  30. Ott K, Lordick F, Molls M, et al. Limited resection and free jejunal graft interposition for squamous cell carcinoma of the cervical oesophagus. Br J Surg 2009; 96:258.
  31. Mayanagi S, Onitsuka T, Nakagawa M, et al. The use of short segment free jejunal transfer as salvage surgery for cervical esophageal and hypopharyngeal cancer. World J Surg 2014; 38:144.
  32. Pesko P, Sabljak P, Bjelovic M, et al. Surgical treatment and clinical course of patients with hypopharyngeal carcinoma. Dis Esophagus 2006; 19:248.
  33. Hosch SB, Stoecklein NH, Pichlmeier U, et al. Esophageal cancer: the mode of lymphatic tumor cell spread and its prognostic significance. J Clin Oncol 2001; 19:1970.
  34. Nigro JJ, Hagen JA, DeMeester TR, et al. Prevalence and location of nodal metastases in distal esophageal adenocarcinoma confined to the wall: implications for therapy. J Thorac Cardiovasc Surg 1999; 117:16.
  35. Kato H, Tachimori Y, Watanabe H, et al. Intramural metastasis of thoracic esophageal carcinoma. Int J Cancer 1992; 50:49.
  36. Stein HJ, Hutter J, Feith M, von Rahden BH. Limited surgical resection and jejunal interposition for early adenocarcinoma of the distal esophagus. Semin Thorac Cardiovasc Surg 2007; 19:72.
  37. Korst RJ, Altorki NK. Extent of resection and lymphadenectomy in early Barrett's cancer. Dis Esophagus 1997; 10:172.
  38. Collard JM, Romagnoli R, Hermans BP, Malaise J. Radical esophageal resection for adenocarcinoma arising in Barrett's esophagus. Am J Surg 1997; 174:307.
  39. Igaki H, Kato H, Tachimori Y, et al. Prognostic evaluation for squamous cell carcinomas of the lower thoracic esophagus treated with three-field lymph node dissection. Eur J Cardiothorac Surg 2001; 19:887.
  40. Fujita H, Kakegawa T, Yamana H, et al. Mortality and morbidity rates, postoperative course, quality of life, and prognosis after extended radical lymphadenectomy for esophageal cancer. Comparison of three-field lymphadenectomy with two-field lymphadenectomy. Ann Surg 1995; 222:654.
  41. Osugi H, Takemura M, Takada N, et al. Prognostic factors after oesophagectomy and extended lymphadenectomy for squamous oesophageal cancer. Br J Surg 2002; 89:909.
  42. Watanabe H, Kato H, Tachimori Y. Significance of extended systemic lymph node dissection for thoracic esophageal carcinoma in Japan. Recent Results Cancer Res 2000; 155:123.
  43. Tachibana M, Kinugasa S, Yoshimura H, et al. Clinical outcomes of extended esophagectomy with three-field lymph node dissection for esophageal squamous cell carcinoma. Am J Surg 2005; 189:98.
  44. Shim YM, Kim HK, Kim K. Comparison of survival and recurrence pattern between two-field and three-field lymph node dissections for upper thoracic esophageal squamous cell carcinoma. J Thorac Oncol 2010; 5:707.
  45. Hsu PK, Wang BY, Chou TY, et al. The total number of resected lymph node is not a prognostic factor for recurrence in esophageal squamous cell carcinoma patients undergone transthoracic esophagectomy. J Surg Oncol 2011; 103:416.
  46. Cense HA, Visser MR, van Sandick JW, et al. Quality of life after colon interposition by necessity for esophageal cancer replacement. J Surg Oncol 2004; 88:32.
  47. Mansour KA, Bryan FC, Carlson GW. Bowel interposition for esophageal replacement: twenty-five-year experience. Ann Thorac Surg 1997; 64:752.
  48. Davis PA, Law S, Wong J. Colonic interposition after esophagectomy for cancer. Arch Surg 2003; 138:303.
  49. DeMeester SR. Colon interposition following esophagectomy. Dis Esophagus 2001; 14:169.
  50. Swisher SG, Hofstetter WL, Miller MJ. The supercharged microvascular jejunal interposition. Semin Thorac Cardiovasc Surg 2007; 19:56.
  51. Rao YG, Pal S, Pande GK, et al. Transhiatal esophagectomy for benign and malignant conditions. Am J Surg 2002; 184:136.
  52. Ellis FH Jr, Gibb SP, Watkins E Jr. Esophagogastrectomy. A safe, widely applicable, and expeditious form of palliation for patients with carcinoma of the esophagus and cardia. Ann Surg 1983; 198:531.
  53. Orringer MB, Marshall B, Chang AC, et al. Two thousand transhiatal esophagectomies: changing trends, lessons learned. Ann Surg 2007; 246:363.
  54. Orringer MB, Marshall B, Iannettoni MD. Transhiatal esophagectomy: clinical experience and refinements. Ann Surg 1999; 230:392.
  55. Macha M, Whyte RI. The current role of transhiatal esophagectomy. Chest Surg Clin N Am 2000; 10:499.
  56. van Sandick JW, van Lanschot JJ, ten Kate FJ, et al. Indicators of prognosis after transhiatal esophageal resection without thoracotomy for cancer. J Am Coll Surg 2002; 194:28.
  57. Paç M, Başoglu A, Koçak H, et al. Transhiatal versus transthoracic esophagectomy for esophageal cancer. J Thorac Cardiovasc Surg 1993; 106:205.
  58. Chang AC, Ji H, Birkmeyer NJ, et al. Outcomes after transhiatal and transthoracic esophagectomy for cancer. Ann Thorac Surg 2008; 85:424.
  59. Baba M, Aikou T, Natsugoe S, et al. Appraisal of ten-year survival following esophagectomy for carcinoma of the esophagus with emphasis on quality of life. World J Surg 1997; 21:282.
  60. Urschel JD. Esophagogastrostomy anastomotic leaks complicating esophagectomy: a review. Am J Surg 1995; 169:634.
  61. Müller JM, Erasmi H, Stelzner M, et al. Surgical therapy of oesophageal carcinoma. Br J Surg 1990; 77:845.
  62. Patil PK, Patel SG, Mistry RC, et al. Cancer of the esophagus: esophagogastric anastomotic leak--a retrospective study of predisposing factors. J Surg Oncol 1992; 49:163.
  63. Agrawal S, Deshmukh SP, Patil PK, et al. Intrathoracic anastomosis after oesophageal resection for cancer. J Surg Oncol 1996; 63:52.
  64. Whooley BP, Law S, Alexandrou A, et al. Critical appraisal of the significance of intrathoracic anastomotic leakage after esophagectomy for cancer. Am J Surg 2001; 181:198.
  65. Griffin SM, Lamb PJ, Dresner SM, et al. Diagnosis and management of a mediastinal leak following radical oesophagectomy. Br J Surg 2001; 88:1346.
  66. Price TN, Nichols FC, Harmsen WS, et al. A comprehensive review of anastomotic technique in 432 esophagectomies. Ann Thorac Surg 2013; 95:1154.
  67. Mathisen DJ, Grillo HC, Wilkins EW Jr, et al. Transthoracic esophagectomy: a safe approach to carcinoma of the esophagus. Ann Thorac Surg 1988; 45:137.
  68. Ellis FH Jr, Heatley GJ, Krasna MJ, et al. Esophagogastrectomy for carcinoma of the esophagus and cardia: a comparison of findings and results after standard resection in three consecutive eight-year intervals with improved staging criteria. J Thorac Cardiovasc Surg 1997; 113:836.
  69. Akiyama H, Tsurumaru M, Watanabe G, et al. Development of surgery for carcinoma of the esophagus. Am J Surg 1984; 147:9.
  70. Turnbull AD, Ginsberg RJ. Options in the surgical treatment of esophageal carcinoma. Chest Surg Clin N Am 1994; 4:315.
  71. Visbal AL, Allen MS, Miller DL, et al. Ivor Lewis esophagogastrectomy for esophageal cancer. Ann Thorac Surg 2001; 71:1803.
  72. Griffin SM, Shaw IH, Dresner SM. Early complications after Ivor Lewis subtotal esophagectomy with two-field lymphadenectomy: risk factors and management. J Am Coll Surg 2002; 194:285.
  73. Boyle MJ, Franceschi D, Livingstone AS. Transhiatal versus transthoracic esophagectomy: complication and survival rates. Am Surg 1999; 65:1137.
  74. Stark SP, Romberg MS, Pierce GE, et al. Transhiatal versus transthoracic esophagectomy for adenocarcinoma of the distal esophagus and cardia. Am J Surg 1996; 172:478.
  75. Chu KM, Law SY, Fok M, Wong J. A prospective randomized comparison of transhiatal and transthoracic resection for lower-third esophageal carcinoma. Am J Surg 1997; 174:320.
  76. Omloo JM, Lagarde SM, Hulscher JB, et al. Extended transthoracic resection compared with limited transhiatal resection for adenocarcinoma of the mid/distal esophagus: five-year survival of a randomized clinical trial. Ann Surg 2007; 246:992.
  77. Goldminc M, Maddern G, Le Prise E, et al. Oesophagectomy by a transhiatal approach or thoracotomy: a prospective randomized trial. Br J Surg 1993; 80:367.
  78. Rentz J, Bull D, Harpole D, et al. Transthoracic versus transhiatal esophagectomy: a prospective study of 945 patients. J Thorac Cardiovasc Surg 2003; 125:1114.
  79. Hulscher JB, Tijssen JG, Obertop H, van Lanschot JJ. Transthoracic versus transhiatal resection for carcinoma of the esophagus: a meta-analysis. Ann Thorac Surg 2001; 72:306.
  80. Krasna MJ. Left transthoracic esophagectomy. Chest Surg Clin N Am 1995; 5:543.
  81. Swanson SJ, Batirel HF, Bueno R, et al. Transthoracic esophagectomy with radical mediastinal and abdominal lymph node dissection and cervical esophagogastrostomy for esophageal carcinoma. Ann Thorac Surg 2001; 72:1918.
  82. Swanson SJ, Sugarbaker DJ. The three-hole esophagectomy. The Brigham and Women's Hospital approach (modified McKeown technique). Chest Surg Clin N Am 2000; 10:531.
  83. McKeown KC. Total three-stage oesophagectomy for cancer of the oesophagus. Br J Surg 1976; 63:259.
  84. McKeown KC. The surgical treatment of carcinoma of the oesophagus. A review of the results in 478 cases. J R Coll Surg Edinb 1985; 30:1.
  85. Finley FJ, Lamy A, Clifton J, et al. Gastrointestinal function following esophagectomy for malignancy. Am J Surg 1995; 169:471.
  86. Vigneswaran WT, Trastek VF, Pairolero PC, et al. Transhiatal esophagectomy for carcinoma of the esophagus. Ann Thorac Surg 1993; 56:838.
  87. Ito H, Clancy TE, Osteen RT, et al. Adenocarcinoma of the gastric cardia: what is the optimal surgical approach? J Am Coll Surg 2004; 199:880.
  88. Barbour AP, Rizk NP, Gonen M, et al. Adenocarcinoma of the gastroesophageal junction: influence of esophageal resection margin and operative approach on outcome. Ann Surg 2007; 246:1.
  89. Hulscher JB, van Sandick JW, de Boer AG, et al. Extended transthoracic resection compared with limited transhiatal resection for adenocarcinoma of the esophagus. N Engl J Med 2002; 347:1662.
  90. Sasako M, Sano T, Yamamoto S, et al. Left thoracoabdominal approach versus abdominal-transhiatal approach for gastric cancer of the cardia or subcardia: a randomised controlled trial. Lancet Oncol 2006; 7:644.
  91. Schiesser M, Schneider PM. Surgical strategies for adenocarcinoma of the esophagogastric junction. Recent Results Cancer Res 2010; 182:93.
  92. Kurokawa Y, Sasako M, Sano T, et al. Ten-year follow-up results of a randomized clinical trial comparing left thoracoabdominal and abdominal transhiatal approaches to total gastrectomy for adenocarcinoma of the oesophagogastric junction or gastric cardia. Br J Surg 2015; 102:341.
  93. Biere SS, van Berge Henegouwen MI, Maas KW, et al. Minimally invasive versus open oesophagectomy for patients with oesophageal cancer: a multicentre, open-label, randomised controlled trial. Lancet 2012; 379:1887.
  94. Santillan AA, Farma JM, Meredith KL, et al. Minimally invasive surgery for esophageal cancer. J Natl Compr Canc Netw 2008; 6:879.
  95. Wang H, Shen Y, Feng M, et al. Outcomes, quality of life, and survival after esophagectomy for squamous cell carcinoma: A propensity score-matched comparison of operative approaches. J Thorac Cardiovasc Surg 2015; 149:1006.
  96. Law S, Fok M, Chu KM, Wong J. Thoracoscopic esophagectomy for esophageal cancer. Surgery 1997; 122:8.
  97. Yamamoto S, Kawahara K, Maekawa T, et al. Minimally invasive esophagectomy for stage I and II esophageal cancer. Ann Thorac Surg 2005; 80:2070.
  98. Akaishi T, Kaneda I, Higuchi N, et al. Thoracoscopic en bloc total esophagectomy with radical mediastinal lymphadenectomy. J Thorac Cardiovasc Surg 1996; 112:1533.
  99. Osugi H, Takemura M, Higashino M, et al. A comparison of video-assisted thoracoscopic oesophagectomy and radical lymph node dissection for squamous cell cancer of the oesophagus with open operation. Br J Surg 2003; 90:108.
  100. Smithers BM, Gotley DC, McEwan D, et al. Thoracoscopic mobilization of the esophagus. A 6 year experience. Surg Endosc 2001; 15:176.
  101. Berrisford RG, Wajed SA, Sanders D, Rucklidge MW. Short-term outcomes following total minimally invasive oesophagectomy. Br J Surg 2008; 95:602.
  102. Roig-García J, Gironés-Vilà J, Garsot-Savall E, et al. [Transthoracic and transhiatal esophagectomy using minimally invasive techniques. Experience in 50 patients]. Cir Esp 2008; 83:180.
  103. Nagpal K, Ahmed K, Vats A, et al. Is minimally invasive surgery beneficial in the management of esophageal cancer? A meta-analysis. Surg Endosc 2010; 24:1621.
  104. Dantoc M, Cox MR, Eslick GD. Evidence to support the use of minimally invasive esophagectomy for esophageal cancer: a meta-analysis. Arch Surg 2012; 147:768.
  105. Mamidanna R, Bottle A, Aylin P, et al. Short-term outcomes following open versus minimally invasive esophagectomy for cancer in England: a population-based national study. Ann Surg 2012; 255:197.
  106. Gurusamy KS, Pallari E, Midya S, Mughal M. Laparoscopic versus open transhiatal oesophagectomy for oesophageal cancer. Cochrane Database Syst Rev 2016; 3:CD011390.
  107. Petropoulos K, Macheras A, Liakakos T, et al. Minimally invasive esophagectomy for esophageal cancer: techniques and outcomes. Chirurgia (Bucur) 2015; 110:99.
  108. Johansson J, Djerf P, Oberg S, et al. Two different surgical approaches in the treatment of adenocarcinoma at the gastroesophageal junction. World J Surg 2008; 32:1013.
  109. Dapri G, Himpens J, Cadière GB. Minimally invasive esophagectomy for cancer: laparoscopic transhiatal procedure or thoracoscopy in prone position followed by laparoscopy? Surg Endosc 2008; 22:1060.
  110. Galvani CA, Gorodner MV, Moser F, et al. Robotically assisted laparoscopic transhiatal esophagectomy. Surg Endosc 2008; 22:188.
  111. Braghetto I, Csendes A, Cardemil G, et al. Open transthoracic or transhiatal esophagectomy versus minimally invasive esophagectomy in terms of morbidity, mortality and survival. Surg Endosc 2006; 20:1681.
  112. Avital S, Zundel N, Szomstein S, Rosenthal R. Laparoscopic transhiatal esophagectomy for esophageal cancer. Am J Surg 2005; 190:69.
  113. Luketich JD, Alvelo-Rivera M, Buenaventura PO, et al. Minimally invasive esophagectomy: outcomes in 222 patients. Ann Surg 2003; 238:486.
  114. Singh RK, Pham TH, Diggs BS, et al. Minimally invasive esophagectomy provides equivalent oncologic outcomes to open esophagectomy for locally advanced (stage II or III) esophageal carcinoma. Arch Surg 2011; 146:711.
  115. Luketich JD, Pennathur A, Awais O, et al. Outcomes after minimally invasive esophagectomy: review of over 1000 patients. Ann Surg 2012; 256:95.
  116. Smithers BM, Gotley DC, Martin I, Thomas JM. Comparison of the outcomes between open and minimally invasive esophagectomy. Ann Surg 2007; 245:232.
  117. Chan DS, Reid TD, Howell I, Lewis WG. Systematic review and meta-analysis of the influence of circumferential resection margin involvement on survival in patients with operable oesophageal cancer. Br J Surg 2013; 100:456.
  118. College of American Pathologists. Surgical Pathology Cancer Case Summary (Checklist): Esophagus. College of American Pathologists: Northfield, 2005.
  119. Mapstone N. Minimum Dataset for Oeophageal Carcinoma Histopathology Reports (1st edn). Royal College of Pathologists: London, 1998.
  120. Mapstone N. Dataset for the Histopathological Reporting of Oesophageal Carcinoma (2nd edn). Royal College of Pathologists: London, 2006.
  121. Greenstein AJ, Litle VR, Swanson SJ, et al. Effect of the number of lymph nodes sampled on postoperative survival of lymph node-negative esophageal cancer. Cancer 2008; 112:1239.
  122. Schwarz RE, Smith DD. Clinical impact of lymphadenectomy extent in resectable esophageal cancer. J Gastrointest Surg 2007; 11:1384.
  123. Peyre CG, Hagen JA, DeMeester SR, et al. The number of lymph nodes removed predicts survival in esophageal cancer: an international study on the impact of extent of surgical resection. Ann Surg 2008; 248:549.
  124. Rizk NP, Ishwaran H, Rice TW, et al. Optimum lymphadenectomy for esophageal cancer. Ann Surg 2010; 251:46.
  125. Li B, Chen H, Xiang J, et al. Pattern of lymphatic spread in thoracic esophageal squamous cell carcinoma: A single-institution experience. J Thorac Cardiovasc Surg 2012; 144:778.
  126. Altorki N, Kent M, Ferrara C, Port J. Three-field lymph node dissection for squamous cell and adenocarcinoma of the esophagus. Ann Surg 2002; 236:177.
  127. Hulscher JB, Van Sandick JW, Offerhaus GJ, et al. Prospective analysis of the diagnostic yield of extended en bloc resection for adenocarcinoma of the oesophagus or gastric cardia. Br J Surg 2001; 88:715.
  128. Dresner SM, Griffin SM. Pattern of recurrence following radical oesophagectomy with two-field lymphadenectomy. Br J Surg 2000; 87:1426.
  129. Fujita H, Sueyoshi S, Tanaka T, et al. Optimal lymphadenectomy for squamous cell carcinoma in the thoracic esophagus: comparing the short- and long-term outcome among the four types of lymphadenectomy. World J Surg 2003; 27:571.
  130. Nishihira T, Hirayama K, Mori S. A prospective randomized trial of extended cervical and superior mediastinal lymphadenectomy for carcinoma of the thoracic esophagus. Am J Surg 1998; 175:47.
  131. Saluja SS, Ray S, Pal S, et al. Randomized trial comparing side-to-side stapled and hand-sewn esophagogastric anastomosis in neck. J Gastrointest Surg 2012; 16:1287.
  132. Kim RH, Takabe K. Methods of esophagogastric anastomoses following esophagectomy for cancer: A systematic review. J Surg Oncol 2010; 101:527.
  133. Biere SS, Maas KW, Cuesta MA, van der Peet DL. Cervical or thoracic anastomosis after esophagectomy for cancer: a systematic review and meta-analysis. Dig Surg 2011; 28:29.
  134. Law S, Fok M, Chu KM, Wong J. Comparison of hand-sewn and stapled esophagogastric anastomosis after esophageal resection for cancer: a prospective randomized controlled trial. Ann Surg 1997; 226:169.
  135. Hsu HH, Chen JS, Huang PM, et al. Comparison of manual and mechanical cervical esophagogastric anastomosis after esophageal resection for squamous cell carcinoma: a prospective randomized controlled trial. Eur J Cardiothorac Surg 2004; 25:1097.
  136. Beitler AL, Urschel JD. Comparison of stapled and hand-sewn esophagogastric anastomoses. Am J Surg 1998; 175:337.
  137. Collard JM, Romagnoli R, Goncette L, et al. Terminalized semimechanical side-to-side suture technique for cervical esophagogastrostomy. Ann Thorac Surg 1998; 65:814.
  138. Orringer MB, Marshall B, Iannettoni MD. Eliminating the cervical esophagogastric anastomotic leak with a side-to-side stapled anastomosis. J Thorac Cardiovasc Surg 2000; 119:277.
  139. Ercan S, Rice TW, Murthy SC, et al. Does esophagogastric anastomotic technique influence the outcome of patients with esophageal cancer? J Thorac Cardiovasc Surg 2005; 129:623.
  140. Honda M, Kuriyama A, Noma H, et al. Hand-sewn versus mechanical esophagogastric anastomosis after esophagectomy: a systematic review and meta-analysis. Ann Surg 2013; 257:238.
  141. Walther B, Johansson J, Johnsson F, et al. Cervical or thoracic anastomosis after esophageal resection and gastric tube reconstruction: a prospective randomized trial comparing sutured neck anastomosis with stapled intrathoracic anastomosis. Ann Surg 2003; 238:803.
  142. Urschel JD, Urschel DM, Miller JD, et al. A meta-analysis of randomized controlled trials of route of reconstruction after esophagectomy for cancer. Am J Surg 2001; 182:470.
  143. Collard JM, Tinton N, Malaise J, et al. Esophageal replacement: gastric tube or whole stomach? Ann Thorac Surg 1995; 60:261.
  144. Ngan SY, Wong J. Lengths of different routes for esophageal replacement. J Thorac Cardiovasc Surg 1986; 91:790.
  145. Lanuti M, de Delva PE, Wright CD, et al. Post-esophagectomy gastric outlet obstruction: role of pyloromyotomy and management with endoscopic pyloric dilatation. Eur J Cardiothorac Surg 2007; 31:149.
  146. Urschel JD, Blewett CJ, Young JE, et al. Pyloric drainage (pyloroplasty) or no drainage in gastric reconstruction after esophagectomy: a meta-analysis of randomized controlled trials. Dig Surg 2002; 19:160.
  147. Atkins BZ, Shah AS, Hutcheson KA, et al. Reducing hospital morbidity and mortality following esophagectomy. Ann Thorac Surg 2004; 78:1170.
  148. Gockel I, Kneist W, Keilmann A, Junginger T. Recurrent laryngeal nerve paralysis (RLNP) following esophagectomy for carcinoma. Eur J Surg Oncol 2005; 31:277.
  149. POISE Study Group, Devereaux PJ, Yang H, et al. Effects of extended-release metoprolol succinate in patients undergoing non-cardiac surgery (POISE trial): a randomised controlled trial. Lancet 2008; 371:1839.
  150. Devereaux PJ, Guyatt G, Yang H, et al. Essay for the CIHR/CMAJ award: impact of the Perioperative Ischemic Evaluation (POISE) trial. CMAJ 2011; 183:E351.
  151. Geerts WH, Bergqvist D, Pineo GF, et al. Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 2008; 133:381S.
  152. Horlocker TT, Wedel DJ, Rowlingson JC, et al. Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy: American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Third Edition). Reg Anesth Pain Med 2010; 35:64.
  153. Metzger R, Bollschweiler E, Vallböhmer D, et al. High volume centers for esophagectomy: what is the number needed to achieve low postoperative mortality? Dis Esophagus 2004; 17:310.
  154. Bailey SH, Bull DA, Harpole DH, et al. Outcomes after esophagectomy: a ten-year prospective cohort. Ann Thorac Surg 2003; 75:217.
  155. Seely AJ, Ivanovic J, Threader J, et al. Systematic classification of morbidity and mortality after thoracic surgery. Ann Thorac Surg 2010; 90:936.
  156. Shen KR, Harrison-Phipps KM, Cassivi SD, et al. Esophagectomy after anti-reflux surgery. J Thorac Cardiovasc Surg 2010; 139:969.
  157. Blazeby JM, Sanford E, Falk SJ, et al. Health-related quality of life during neoadjuvant treatment and surgery for localized esophageal carcinoma. Cancer 2005; 103:1791.
  158. Blazeby JM, Farndon JR, Donovan J, Alderson D. A prospective longitudinal study examining the quality of life of patients with esophageal carcinoma. Cancer 2000; 88:1781.
  159. de Boer AG, van Lanschot JJ, van Sandick JW, et al. Quality of life after transhiatal compared with extended transthoracic resection for adenocarcinoma of the esophagus. J Clin Oncol 2004; 22:4202.
  160. Reynolds JV, McLaughlin R, Moore J, et al. Prospective evaluation of quality of life in patients with localized oesophageal cancer treated by multimodality therapy or surgery alone. Br J Surg 2006; 93:1084.
  161. Viklund P, Wengström Y, Rouvelas I, et al. Quality of life and persisting symptoms after oesophageal cancer surgery. Eur J Cancer 2006; 42:1407.
  162. Parameswaran R, McNair A, Avery KN, et al. The role of health-related quality of life outcomes in clinical decision making in surgery for esophageal cancer: a systematic review. Ann Surg Oncol 2008; 15:2372.
  163. Djärv T, Lagergren J, Blazeby JM, Lagergren P. Long-term health-related quality of life following surgery for oesophageal cancer. Br J Surg 2008; 95:1121.
  164. Djärv T, Blazeby JM, Lagergren P. Predictors of postoperative quality of life after esophagectomy for cancer. J Clin Oncol 2009; 27:1963.
  165. Gockel I, Gönner U, Domeyer M, et al. Long-term survivors of esophageal cancer: disease-specific quality of life, general health and complications. J Surg Oncol 2010; 102:516.
  166. Hurmuzlu M, Aarstad HJ, Aarstad AK, et al. Health-related quality of life in long-term survivors after high-dose chemoradiotherapy followed by surgery in esophageal cancer. Dis Esophagus 2011; 24:39.
  167. Derogar M, Orsini N, Sadr-Azodi O, Lagergren P. Influence of major postoperative complications on health-related quality of life among long-term survivors of esophageal cancer surgery. J Clin Oncol 2012; 30:1615.
  168. Derogar M, Lagergren P. Health-related quality of life among 5-year survivors of esophageal cancer surgery: a prospective population-based study. J Clin Oncol 2012; 30:413.
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