Ösophagektomie

Ösophagektomie

Esophagectomy is a surgical procedure that involves excision of the majority of the esophagus and part of the proximal stomach, usually as a treatment for esophageal carcinoma or carcinoma of the gastric cardia, although benign conditions (e.g. stricture) may - rarely - be treated with this approach.

Esophagectomies are usually classified as either:

• transthoracic esophagectomy: more complete oncologic approach, higher pulmonary complication (each procedure requires a thoracotomy) and anastomotic leak risk
  • Ivor Lewis procedure
  • McKeown procedure
  • left thoracoabdominal approach
• transhiatal esophagectomy

There are also different types of esophageal interposition:

• gastric pull-up (most common)
• colonic interposition
• jejunal interposition

Complications

These surgeries are technically demanding and have a high complication rate. Complications depend on the type of esophagectomy, but include

• pulmonary complications, esp. with a transthoracic approach
  • highest mortality rate
• leak (with possible subsequent mediastinitis)
  • anastomosis (most common site)
  • gastric staple line
  • at pyloroplasty
• recurrent laryngeal nerve injury
• hemorrhage
• chylothorax
• delayed gastric emptying
• dumping syndrome
• anastomotic stricture
• recurrent disease

See: fluoroscopic evaluation of esophagectomy

Siehe auch:

• Ösophaguskarzinom
• Komplikationen nach Ösophagektomie