High Thoracoscopic Intrathoracic Anastomosis for Mid-Esophageal Cancer

An intrathoracic esophago-gastric anastomosis has the potential to reduce morbidity and mortality in patients undergoing minimally invasive esophagectomy (MIE) for cancer. Esophageal squamous cell carcinoma (SCC) has a high incidence of early lymphatic spread and is usually located in the midthorax, in comparison to esophageal adenocarcinoma. Consequently, the anastomosis should be made high in the thorax or in the neck. A high intrathoracic anastomosis using thoracoscopy, if applicable, is an attractive alternative procedure to a cervical anastomosis, to reduce the incidence of complications such as vocal cord palsy and anastomotic leak. The authors present their experiences and outcomes with patients with esophageal squamous cell carcinoma treated by high intrathoracic circular anastomosis using a thoracoscopic technique.