Larynx-preserving resection of the cervical esophagus for cervical esophageal carcinoma limited to the submucosal layer

This report describes the surgical procedure consisting of larynx-preserving resection of the cervical esophagus and satisfactory lymphadenectomy. The sternum was split at the level of the 3rd intercostal space, which allowed an upper-mediastinal lymphadenectomy to be performed easily. The cervical esophagus was reconstructed using a free jejunal autograft. The stump of the thoracic esophagus and the caudad stump of the jejunal graft were anastomosed using a circular stapling instrument. The posterior part of the cephalad esophagojejunostomy was completed in two layers using the Lembert stitch. The wall of the cervical esophagus was opened to determine the oral cut line considering the safety margin from the carcinoma. After cervical esophagectomy was completed, suturing of the anterior wall was performed in one layer. The left cervical transverse artery and the internal jugular vein were employed for recipient vessels. This procedure is acceptable for high cervical esophageal carcinoma Limited to the submucosal layer. (C) 1998 Wiley-Liss, Inc.