2004, Number 3
Approach to the cervical esophagus
Etchegaray-Dondé A, Hurtado-López LM
Full text
Language: Spanish
References: 10
Page: 169-172
PDF size: 162.94 Kb.
ABSTRACT
Introduction: Traditionally, the cervical esophagus has been approached obliquely. Our concept is that the transverse approach is another access route, with good exposure and low morbidity. We present the experience of our surgical team.Patients and methods: Retrospective, descriptive, transversal study in 21 patients subjected to a transverse approach of the cervical esophagus. We analyzed direct variables such as visualization of structures, exposure, lesions, fistulae, stenosis, and accidents.
Results: Transverse approach to the esophagus was performed in 21 patients, 8 with benign pathology and 13 with malignant pathology. From the eight patients with benign pathology, three coursed with Zenker diverticulum, three with perforations, and two had lesions caused by caustic burns. The patients with malignant pathology corresponded to eleven with esophageal cancer, two with tumors of the esophagogastric junction. An excellent exposure of the structures was achieved in all patients, even in three patients that were re-operated. We had two patients with lesions of the recurrent laryngeal nerve, only one (4.7%) was left with a permanent lesion. Three (14.7%) patients presented an anastomotic fistula, two of them developed stenosis. No patient presented vascular lesions (accidental, esophageal, or of the airways).
Discussion: Comparing our results with those reported in the world literature, we found less frequency of recurrent laryngeal nerve lesions, and less or equal fistulae and stenoses. Besides this approach has the advantage of being able to extend the incision to approach the right side when necessary and, from our point of view, produces better esthetic results.
Conclusion: The transverse approach of the esophagus is a safe route, with low morbidity, with the same or better exposure than the oblique approach.
REFERENCES