Transhiatal Esophagectomy




Indications



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  • Resectable esophageal carcinoma.
  • Barrett esophagus with high-grade dysplasia.
  • Carcinoma of the cardia or proximal stomach.
  • Achalasia.
  • Advanced disease (mega-esophagus).
  • Failed esophagomyotomy.
  • Benign (undilatable) stricture.
  • Recurrent hiatal hernia or reflux esophagitis following multiple hiatal hernia repairs.




Contraindications



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Absolute




  • Biopsy-proven distant metastatic (stage IV) esophageal cancer.
  • Tracheobronchial invasion by upper or mid-third tumors visualized on bronchoscopy.
  • Aortic invasion demonstrated on MRI, CT scan, or endoscopic ultrasound (EUS).




Relative




  • Cardiopulmonary comorbidities.
  • Previous esophageal surgery causing excessive mediastinal adhesions.
  • Previous radiation therapy (more than 6–12 months prior) causing mediastinal and esophageal radiation fibrosis.


Jan 8, 2019 | Posted by in UROLOGY | Comments Off on Transhiatal Esophagectomy
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