Bilateral thoracotomy and inferior sternotomy for bypass grafting after esophagostomy

In the presence of a cervical esophagostomy, a median sternotomy may jeopardize the stoma, risk mediastinal or sternal infection, and potentially compromise future esophageal operations. Coronary artery bypass grafting was performed using a modified bilateral thoracotomy before esophageal reconstruction in a patient with cervical esophagostomy. The surgical technique is described with a review of the relevant literature. (C) 1997 by The Society of Thoracic Surgeons.