All of the following are surgical options in management of esophageal carcinoma except -
Ans. is 'd' i.e., Sistrunk operation Surgery in Ca esophagus1 .Ivor lewis operation - is subtotal esophagectomy done for Ca esophagus in lower third of esophagus. Part of stomach and esophagus are resected and remnants of both anastomosed.2. In transhiatal esophagectomy (THE) the thorax dosen't needs to be opened. Esophagus is removed through the diaphragmatic hiatus by making incisions in the abdomen and the neck.# In this operation, first an upper abdominal incision is made. The surgeon mobilizes the esophagus by working upward through the diaphragmatic hiatus. With the addition of an incision on the left side of the neck, the surgeon completes the mobilization of the esophagus, removes it, and moves the stomach upward through the hiatus and into the chest until its upper end appears in the neck wound. The remaining esophagus is connected to the stomach in the neck (cervical esophagogastric anastomosis).# Advantages of Transhiatal esophagectomy over transthoracic esophagectomy:o The two leading causes of morbidity and mortality in the first few days after a transthoracic esophagectomy are:1. Lung complications (especially pneumonia) associated with a large operation that requires opening both the chest and the abdomen. The pain of these combined incisions may make it difficult for the patient to take a deep breath early after the operation, and this allows pneumonia to set in; and2. Severe infection in the chest (mediastinitis) resulting due to a ''leak" from intrathoracic esophagogastric anastomosis.3. McKeowns Surgery-3 Incision Approach
Ivor Lewis Approach
Mckeown's Approach
Transhiatal removal
Sistrunk operation
Esophageal Diseases - Gastroesophageal Reflux Disease, Carcinoma