Laryngological Session: Replacement Surgery for Postcricoid Carcinomas

The operation is best performed in the order set out above. A thoracotomy is not necessary to free the cesophagus: this can be done by blunt, blind finger dissection from above and below, and -this procedure on 7 patients has caused no serious bleeding or complications apart from a pneumothorax. After it has been freed, gentle traction on the cesophagus from above delivers the stomach into the neck. The cardia comes to lie at about the level of the manubrium sterni and the cesophagus is divided from the stomach via the neck incision. In our experience the fundus reaches to the pharynx without undue tension anda wide anastomosis between the two can be performed. The wounds are closed with suction drains into the mediastinum and neck and at the end of the operation a chest X-ray should be taken to exclude a pneumothorax: if there is much air in either pleural cavity this should be aspirated forthwith.