Stapled esophagogastric anastomosis in the apex of the right chest after subtotal esophagectomy for carcinoma.

Using the abdominal-right chest approach for subtotal esophagectomy of carcinoma of the thoracic esophagus by creating an anastomosis in the apex of the chest with a circular stapler, we have found the technique to be expeditious, tidy and safe. Anastomotic leakage occurred in only one of 108 operations. The site of the anastomosis is as high as, if not higher, than the usual three phase esophagectomy with cervical anastomosis, thus demonstrating that subtotal esophagectomy has been achieved. Technical details are quite important for the success of this operation and the method described herein has been shown to be satisfactory.