A new technique of total three-stage esophagectomy for carcinoma with a combined right cervical and thoracic approach

Total esophagectomy with a combined right cervicothoracic approach can be considered to be an extension of the classic right abdominothoracic method. The inclusion of a wide operating field composed of the neck and thorax, as well as the upper right limb, makes the method applicable to both provisional and obligatory operations. The nonobligatory cervical phase constitutes a useful safety approach when frozen section biopsy of the residual esophagus yields positive specimens, if a conventional Lewis-Santy right abdominothoracic procedure has been chosen.