[Subtotal esophagectomy with stomach transposition as standard operation for adenocarcinoma of the esophagogastric junction].

A modified Ivor Lewis operation was introduced to the surgical treatment of adenocarcinoma of the oesophagogastric junction in an investigative study of 122 consecutive patients. The procedure consisted of a transmediastinal subtotal oesophagectomy with mediastinal lymphadenectomy to the level of the tracheal bifurcation, a proximal 4/5th-gastrectomy with D2-lymphadenectomy and splenic hilar dissection and was completed by a collar oesophagogastrostomy using a gastric tube from the greater curvature. The new concept was followed by good oncologic results without anastomotic recurrencies and a reduction in potential lethal complications like mediastinal anastomotic leakage.