Total esophagectomy without thoracotomy for cancer

Total extrathoracic esophagectomy was performed in 16 patients with neoplasms arising in the thoracic and cervical esophagus and the hypopharynx. The procedure was combined with posterior mediastinal gastric pull up in all but two patients who had previous gastrectomy and were managed with colon interposition. Splenectomy was avoided in all patients. Although, in the presence of TNM stage III and IV disease, the procedure was performed mostly for palliation, it resulted in only two deaths and it led to rapid initiation of oral alimentation. Extrathoracic esophagectomy constitutes a safe and simple alternative to other ablative or palliative procedures in the treatment of hypopharyngeal and esophageal malignancies.