Total esophagectomy by right anterior thoracotomy and immediate esophageal reconstruction for carcinoma of the esophagus.

In the past 11 months we treated 12 cases of squamous-cell carcinoma of the esophagus with single-stage total esophagectomy via an anterior thoracotomy and esophageal reconstruction. The stomach was utilized as esophageal substitute in nine patients and the left colon in three, in whom stomach was not available. One patient died. The single fistula from the esophagogastric anastomosis closed spontaneously within two weeks. We believe total esophagectomy to be more successful than partial resection in squamous-cell carcinoma of the esophagus. The right anterior approach in the thorax permits two surgical teams to work simultaneously. As the patient is supine throughout the operation, the cervical, thoracic and abdominal approaches can be effectively checked. The operating time is also shortened.