Surgical Treatment of Esophageal Disease

In comparison to other portions of the alimentary tract, surgery of the esophagus is associated with a greater percentage of postsurgical complications. Prior to surgery, nutritional deficiencies associated with esophageal disease should be considered. Delaying surgery and correcting malnourishment through the use of parenteral solutions, or feeding via pharyngostomy, gastrostomy, or jejunosotomy tubes may be indicated. The major complications associated with esophageal surgery are dehiscence, leakage, and stenosis. Esophagotomy and esophagectomy can be performed on any portion of the esophagus. All the principles of esophageal surgery apply when performing an esophagotomy and an esophagectomy, including minimal mobilization of the esophagus, atraumatic handling of tissue, and postoperative esophageal rest. One of the most substantially complicating aspects of esophageal resection and anastomosis is that the esophagus has little to no redundancy and therefore autologous tissue for reconstruction is usually nonexistent.