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Surgery Transthoracic Esophagectomy

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Esophageal Squamous Cell Carcinoma

Abstract

Surgery has been frequently used to obtain locoregional control and has played a major role in esophageal cancer treatment. Curative resection of the primary lesion needs the removal of the gross lesion itself as well as any possible concomitant spread of the carcinoma. Thoracic esophageal carcinoma is often accompanied by extensive metastasis to the lymph nodes in the cervical, thoracic, and abdominal regions. Because sufficient dissection of the mediastinal lymph nodes is necessary, right thoracotomy and lymph node dissection plus total extirpation of the thoracoabdominal esophagus are generally performed. Transthoracic esophagectomy is one of the most invasive surgeries. The rate of morbidity and mortality for esophagectomy has been decreasing, but still remains high. Substantial advances in preoperative risk evaluation, improved operative techniques, and perioperative management are demanding. In future perspectives, to improve the rate of cure and the quality of life after surgery, more attention should be paid to minimal invasive esophagectomy and the individualization of treatment. Thoracoscopy-assisted esophagectomy including robot-assisted esophagectomy has been reported as promising surgical procedures, in views of its minimal invasiveness, better cosmetics, lesser pain, reduced postoperative respiratory complication, radical curability, and favorable long-term outcomes. If the oncological benefit is proved by the prospective studies, these procedures could become the standard procedures for transthoracic esophagectomy. Sentinel lymph node mapping acquires individual information to allow for adjustments and modifications to surgical procedures for patients. This process might be a procedure that could play a significant role in eliminating the necessity for the uniform application of highly invasive surgery.

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Authors and Affiliations

  1. Department of Surgery, Keio University School of Medicine, Tokyo, Japan

    Hirofumi Kawakubo

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  1. Hirofumi Kawakubo
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Correspondence to Hirofumi Kawakubo .

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  1. International Goodwill Hospital, Yokohama, Japan

    Nobutoshi Ando

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Kawakubo, H. (2020). Surgery Transthoracic Esophagectomy. In: Ando, N. (eds) Esophageal Squamous Cell Carcinoma. Springer, Singapore. https://doi.org/10.1007/978-981-15-4190-2_10

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  • DOI: https://doi.org/10.1007/978-981-15-4190-2_10

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-15-4189-6

  • Online ISBN: 978-981-15-4190-2

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