• 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.

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.