Index

A in short segment colon B Abscess interposition, 81 Barotrauma, as esophageal subhepatic esophagogastric, 70 perforation cause, 9 -related, 33 in gastric cardia carcinoma, 1 Barrett’s esophagogastrectomy-related, Anastomotic leaks esophageal carcinoma associated 34 bile diversion operations-related, with, 6 subphrenic 132 surgical treatment of esophageal perforation repair- cervical with antireflux , 5 related, 155 cervical anastomosis-related, with laparoscopic Nissen esophagectomy-related, 33 9–10 fundoplication, 95–106 esophagogastrectomy-related, 34 intrathoracic anastomosis- Bile diverting operations, 127–133 Achalasia related, 2 after esophagogastrectomy, 128–130 cricopharyngeal, 8 esophagectomy-related, 13, 33 duodenojejunostomy in, pathology of, 10 esophagogastrectomy-related, 34, 128–129, 130 treatment of, 10–11, 139–143 35 complications of, 127, 132 with laparoscopic intrathoracic anastomosis-related, duodenojejunostomy Roux-en-Y esophagomyotomy, 144–149 10 switch operation, 131–132 Allis clamp, 111 nonsurgical treatment of, 10 indications for, 127 Anastomoses surgical treatment of, 10, operative strategy in, 127–128 cervical, 9–10 150–156 after esophagogastrectomy, 128 leakage from, 9–10 transhiatal esophagectomy-related, after failed antireflux strictures of, 71 66, 71 procedures, 127 cologastric, in short segment colon Antibiotic prophylaxis, for operative technique in, 128–132 interposition, 81 postoperative abscesses, 33 pitfalls and danger points in, 127 end-to-end esophageal Antibiotic therapy, for anastomotic preoperative preparation for, 127 complications of, 35–36 leaks, 10 and antrectomy, 127, versus end-to-side anastomosis, Antireflux operations, 6 128 35–36 failed, 7 closure in, 128 stapling technique in, 36 as indication for bile diversion hemigastrectomy in, 128 end-to-side esophageal, 13, 25, 27, procedures, 127 Roux-en-Y reconstruction in, 28 for hiatal /reflux, 4 127, 128 cervical, 29–31 manometry use in, 5 Blast injuries, as thoracic esophageal with enlarged thoracic incision, posterior (Hill repair), perforation cause, 9 50–52 107–114 Boerhaave syndrome, 9 in esophageal replacement, 3 transabdominal Nissen Botulinum toxin, as achalasia in esophagogastrectomy with fundoplication, 85–94 treatment, 10 left thoracoabdominal transthoracic gastroplasty, 81, Bougies, Maloney, 7, 33 approach, 35–36, 50–60 115–126 Bowel herniation with , 55 Antireflux valve, testing of laparoscopic Nissen Nissen fundoplication in, 27 in posterior gastropexy, 114 fundoplication-related, 95, 102 stapled, 27 in transabdominal Nissen transhiatal esophagectomy-related, stapling technique (circular fundoplication, 92–93 66 technique) in, 52, 58–60 Antrectomy, in bile diversion Bypass, esophageal. See Esophageal stapling technique (surgical procedures, 127, 128 replacement or bypass legacy technique) in, 52, Aorta, posterior gastropexy-related procedures 54–58 laceration of, 108, 111 supraaortic, 50–52 Arrhythmias, cardiac, esophagectomy- C suture technique in, 52 related, 33 Candida, esophageal content of, 8 esophagocolonic Azygos vein, transhiatal Celiac artery, in posterior gastropexy in long segment colon esophagectomy-related trauma identification and liberation of, 111 interposition, 79 to, 67 laceration of, 108

157 158 Index

Chest tube drainage, in esophageal Dysphagia complications of, 150, 155 perforation repair, 151, 152, achalasia-related, 10 débridement in, 150–151, 152 155 postoperative esophageal diversion by cervical Chylothorax, transhiatal cricopharyngeal myotomy- esophagostomy, 153–154 esophagectomy-related, 66 related, 138 esophageal occlusion methods, Clamps esophagomyotomy-related, 143 153 Allis, 54, 55 fundoplication-related, 6 exclusion of the esophagus from Babcock, 87, 111, 121 laparoscopic Nissen the , endoscopic, 96, 97 fundoplication-related, 102, 154–155 Mixter, 121 106 intercostal muscle flap repair, Collis-Nissen operation. See posterior gastropexy-related, 151, 152 Gastroplasty, transthoracic 111, 114 operative strategy in, 150 Cologastrostomy, in long segment transabdominal Nissen operative technique in, 150–155 colon interposition, 74–77, fundoplication-related, 86 pitfalls and danger points in, 150 78 Zenker’s (pharyngoesophageal) pleural flap repair, 150–152 Colon interposition diverticulum-related, 8 postoperative care following, disadvantages of, 3–4 155 long segment, 73–79 E preoperative preparation for, advancement of the colon in, 77, Emphysema, mediastinal, 9 150 79 Empyema, esophagomyotomy-related, of thoracic esophagus, 9 cervical esophagus dissection in, 143 transthoracic gastroplasty-related, 79 Endoscopes, as esophageal 115 closure of, 801 perforation cause, 9 Esophageal replacement or bypass cologastrostomy in, 74–77, 78 Epidural analgesia/anesthesia procedures, 3–4, 73–84 esophagocolonic anastomosis in, in esophagectomy patients, 33 colon interposition, long segment, 79 in esophagogastrectomy with left 73–79 estimation of required length of thoracoabdominal approach, advancement of the colon in, 77, colon in, 74, 75 34 79 in, 77 in gastric cardia patients, 1 cervical esophagus dissection in, retrosternal passage of colon Esophageal carcinoma 79 transplant in, 79, 80–81 of the cardiac region, 1 closure of, 801 short segment, 79, 81 surgical treatment of cologastrostomy in, 74–77, 78 cologastric anastomosis in, 81 with esophagectomy with right esophagocolonic anastomosis in, esophagocolonic anastomosis thoracotomy and , 79 in, 81 13–33 estimation of required length of in unresectable esophageal with esophagogastrectomy with colon in, 74, 75 carcinoma, 2 left thoracoabdominal pyloromyotomy in, 77 Cricopharyngeus muscle, 7 approach, 34–65 retrosternal passage of colon with thoracic esophageal transplant in, 79, 80–81 D reconstruction, 29 colon interposition, short segment, Diaphragm transhiatal approach in, 2–3, 79, 81 incision of, in 66–71 cologastric anastomosis in, 81 esophagogastrectomy with transthoracic approach in, 2–3 esophagocolonic anastomosis in, left thoracoabdominal unresectable, 2 81 approach, 38, 39 Esophageal hiatus, enlargement of, 13 indications for, 73 paralysis of, esophagogastrectomy- Esophageal perforations, 8–9 jejunum interposition, 81–83 related, 34 antibiotic therapy for, 9 with Collis-Nissen gastroplasty, Dilators of cervical esophagus, 8, 9 81 as esophageal perforation cause, “conservative” management of, 8 esophagojejunostomy in, 82 9 delayed diagnosis of, 150 incision in, 81 Goodall cervical, 111 esophagitis as risk factor for, 108 jejunogastrostomy in, 82, 83 Maloney, 105, 115, 137 laparoscopic esophagomyotomy- jejunojejunostomy in, 82 in transthoracic gastroplasty, related, 144, 149 mobilization of jejunum graft in, 120, 121–122, 124 laparoscopic Nissen 82 Diverticulum, pharyngoesophageal. fundoplication-related, 95, 98, pyloromyotomy in, 83 See Zenker’s 100, 105, 106 pyloroplasty in, 83 (pharyngoesophageal) occult, 10 resection of diseased esophagus diverticulum operative repair of, 9, 150–156 in, 81–82 Duodenojejunostomy Roux-en-Y with colon or jejunum Stamm in, 82 switch operation, 131 interpositions, 73–81 operative strategy in, 73 Index 159

operative technique in, 73–83 pyloromyotomy in, 21–23 pyloromyotomy in, 45 incision, 73 stapled esophagogastric splenectomy in, 40, 42 long segment colon anastomosis in, 27 stabilization of the gastric pouch interposition, 73–79 transhiatal, 2–3, 66–71 in, 60–61 resection of the esophagus, 73 abdomen in, 67 stapling technique in, 36 short segment colon cervical dissection in, 66–67 transection of and interposition, 79, 81 closure of, 71–72 esophagus in, 45–48 preoperative preparation for, 73 complications of, 66, 71 Esophagogastric junction stomach interposition for, 3 Kocher maneuver in, 67 in esophageal perforation repair, 9 Esophageal strictures. See Strictures, operative strategy in, 66–67 in paraesophageal , 5 esophageal operative technique in, 67–71 in posterior gastropexy (Hill Esophageal surgery. See also specific pitfalls and danger points in, 66 repair), 108–111 esophageal surgical preoperative preparation for, 66 in transabdominal Nissen procedures pyloromyotomy in, 67 fundoplication, 85, 86–87, 91 concepts in, 1–12 transhiatal dissection in, 67–70, Esophagogastroduodenoscopy, prior achalasia, 10–11 71 to transabdominal Nissen anastomotic leaks, 8, 9–10 Esophagitis fundoplication, 85 carcinoma of the cardia region, 1 as esophageal perforation risk Esophagojejunostomy carcinoma of the middle and factor, 108 in jejunum interposition, 82 upper esophagus, 1–2 reflux, 5 Roux-en-Y, 1 esophageal perforations, 8–9 esophagogastrectomy-related, 36 Esophagomyotomy hiatal hernia and reflux disease, esophagogastric anastomosis- as achalasia treatment, 139–143, 4–7 related, 27 144–149 motility disorders, 11 esophagomyotomy-related, 143 incision and exposure, 140 pharnygoesophageal as indication for laparoscopic operative strategy in, 139 diverticulum, 7–8 Nissen fundoplication, 95 operative technique in, 140–143 replacement or bypass of the Esophagogastrectomy pitfalls and danger points in, esophagus, 3–4 bile diversion following, 128–130 139 transhiatal approach in duodenojejunostomy in, 128– preoperative preparation for, esophageal carcinoma, 2–3 129 139 transthoracic approach in Roux-en-Y reconstruction in, complications of, 139, 143 esophageal carcinoma, 2–3 129, 130 as diffuse esophageal spasm unresectable carcinoma, 2 left thoracoabdominal approach in, treatment, 139, 143 Esophagectomy 34–65 laparoscopic, 144–149 with right thoracotomy and closure of, 61–64 complications of, 144, 149 laparotomy, 13–33 complications of, 34, 64 esophageal mobilization in, access to proximal esophagus endobronchial one-lung 145–146 in, 13 anesthesia in, 36–37 indications for, 144 advancement of stomach into end-to-side anastomosis in, initial exposure in, 145–146 right chest in, 23–24, 25 35–36, 50–60 myotomy in, 144, 146–148 cervical esophagogastric enlargement of hiatus in, 48, 49, operative strategy, 144–148 anastomosis in, 29–31 50 partial fundoplication in, 148 closure of, 31–32 enlargement of thoracic incision patient positioning in, 144 complications of, 13, 33 in, 50–52 pitfalls and danger points in, 144 esophagogastric anastomosis in, gastric mobilization in, 42–45 preoperative preparation for, 13, 25–27, 28 hiatal dissection in, 45 144 gastroepiploic arcade in, 13, 19 incision in, 36–38, 39–40 trocar placement in, 144 incisions in, 13–17 Kocher maneuver in, 45, 46 postoperative care following, 143 indications for, 13 latissimus dorsi division in, as Zenker’s diverticulum treatment, Kocher maneuver in, 20–21, 22 37–38 137–138 mobilization of the esophagus liberation of the esophagus in, Esophagoscopy, for gastroesophageal in, 16, 17 38, 40, 41 reflux evaluation, 5 mobilization of the stomach in, with Nissen fundoplication, 36, Esophagostomy 17–20 55 anterior thoracic, 150, 154 operative strategy in, 13 operative strategy in, 34–36 cervical, for esophageal diversion, operative technique in, 13–32 operative technique in, 36–64 153–154 patient positioning in, 13 patient positioning in, 37 Esophagus pitfalls and danger points in, 13 pitfalls and danger points in, 34 cervical, division of, 70 postoperative care following, 33 postoperative care following, 64 dissection of preoperative preparation for, 13 preoperative preparation for, 34 in transhiatal esophagectomy, 68 160 Index

Esophagus (cont.) subtotal, as indication for abdominal closure in, 114 exclusion from the gastrointestinal transthoracic gastroplasty, 115 antireflux valve testing in, 114 tract, 151, 154–155 Gastric artery, left calibration of the esophagocardiac intraoperative injury to in esophagogastrectomy, 42, 44 orifice in, 108 during esophageal stricture in transabdominal Nissen complications of, 107, 114 dilation, 120–121 fundoplication, 85 dissection of median arcuate during laparoscopic Nissen Gastric cardia carcinoma, resection ligament in, 107–108 fundoplication, 95 of, 1 Hill’s modification of, 107, 111 mobilization/liberation of Gastric fundus, mobilization of, in identification and liberation of the in esophageal perforation repair, transabdominal Nissen median arcuate ligament in, 150, 153 fundoplication, 85, 87, 90, 91 107, 111–112 in esophagectomy, 16, 17 Gastric pouch incision and exposure techniques in esophagogastrectomy with esophagogastrectomy-related in, 108 left thoracoabdominal ischemia of, 34 insertion of the crural sutures in, approach, 38, 40, 41 stabilization of, in 111 in laparoscopic esophagogastrectomy with liberation of the left lobe of the esophagomyotomy, 145–146 thoracoabdominal approach, in, 108 in laparoscopic Nissen 60–61 mobilization of the fundoplication, 95, 100–102 Gastric pull-up operation, 154–155 esophagogastric junction in, in transthoracic gastroplasty, Gastric tip, transhiatal 108–111 115, 118, 119 esophagectomy-related trauma operative strategy in, 107–108 penetrating trauma to, 152 to, 66 operative technique in, 108–114 perforation of. See Esophageal Gastrocolic reflux, esophageal pitfalls and dangers in, 107 perforation replacement-related, 3 postoperative care following, 114 short, transthoracic gastroplasty Gastroepiploic arcades, 3 suturing techniques in, 112–114 repair of, 115–126 in esophagectomy, 13, 19 Vansant’s modification of, 107, transection of, in in esophagogastrectomy, 42–43 112 esophagogastrectomy, 45, 48, right, in transhiatal esophagectomy, Gastrophrenic ligament 49 67 division of, 67, 110 Gastroepiploic artery, in transhiatal in esophagogastrectomy, 42, 45 F esophagectomy, 66, 67 in transabdominal Nissen Fistulas Gastroesophageal reflux (GER). See fundoplication, 85 esophageal, cricopharyngeal also Esophagitis, reflux identification of, 85 myotomy-related, 138 esophageal strictures associated Gastroplasty, transthoracic (Collis- esophagocutaneous, postoperative, with, 6–7 Nissen procedure), 81, 155 hiatal hernia-related, 4, 5–6 115–126 pancreatic, esophagogastrectomy- postoperative adequacy of gastroplasty in, 115 related, 34 Collis-Nissen procedure-related, closure of the hiatal defect in, 124, Flap repair 126 125 intercostal muscle, of esophageal following posterior gastropexy, complications of, 115, 126 perforation, 152, 153 114 contraindication to, 115 pleural, of thoracic esophageal laparoscopic esophagomyotomy- division of the short gastric vessels perforation, 150–152 related, 144, 149 in, 121 Foley catheter balloon, for preoperative evaluation of, 5 esophageal perforation prevention esophageal lumen dilatation, surgical treatment of, 6 in, 116 55, 58 failure of, 7 esophageal stricture dilation in, Fundoplication. See also Nissen posterior gastropexy (Hill 120–121 fundoplication repair), 107–114 esophagus and stomach abdominal approach in, 6, 7 transabdominal Nissen mobilization in, 115 complications of, 6 fundoplication, 85–94 excision of the hernial sac in, 118, intrathoracic approach in, 7 transthoracic gastroplasty, 119–120 partial 115–126 gastroplasty in, 121–122, 123 Dor, 144, 148 Gastrohepatic ligament hemorrhage prevention in, 115–116 Toupet, 144, 148 division of, 108, 110 incision in, 116–118 thoracic approach in, 6, 7 location of, 85 indications for, 115 proximal, division of, 85 liberation of the esophagus in, 118, G in transthoracic gastroplasty, 118, 119 “Gas bloat,” 93 120 modified Nissen fundoplication in, Gastropexy, posterior (Hill repair), 122, 123, 124 proximal, 1 107–114 neoesophagus in, 115 Index 161

operative strategy in, 115–116 Intercostal muscle flap repair, of prior to transabdominal Nissen operative technique in, 116–125 esophageal perforations, 151, fundoplication, 85 pitfalls and danger points in, 115 152, 153 Median arcuate ligament postoperative care following, 126 Intercostal muscles, division of identification and liberation of, preoperative preparation for, 115 in esophagogastrectomy with left 107, 111–112 Gastrosplenic ligament, in thoracoabdominal approach, Hill’s method for, 107, 111 transabdominal Nissen 38, 39 Vansant’s method for, 107, 112 fundoplication, 85–86 in transthoracic gastroplasty, 116 suturing of, 112 Gastrostomy, Stamm, 154 Intercostal nerves, in Mediastinitis, esophageal perforation- in jejunum interposition, 82 esophagogastrectomy with related, 150–151 Gerota’s fascia, 20–21 left thoracoabdominal Motility disorders, of the esophagus, Graspers, closed, 98, 99 approach, 50, 51 11. See also Achalasia Intestinal obstruction, bile diversion Myotomy. See also H operations-related, 132 Esophagomyotomy;

H2-blockers, 5 Pyloromyotomy Hemigastrectomy, in bile diverting J balloon, as achalasia treatment, procedures, 128 Jejunogastrostomy, in jejunum 10–11 Hemodynamic monitoring, in interposition, 82, 83 cricopharyngeal, as Zenker’s transhiatal esophagectomy Jejunojejunostomy, in jejunum diverticulum treatment, patients, 67 interposition, 82 134–138 Hemorrhage Jejunum interposition, 81–83 closure of, 138 esophagogastrectomy-related, 34 with Collis-Nissen gastroplasty, 81 complications of, 138 posterior gastropexy-related, 111 disadvantages of, 3–4 dissection technique in, 136–137 transhiatal esophagectomy-related, esophagojejunostomy in, 82 incision and exposure in, 66, 67 incision in, 81 134–136 transthoracic gastroplasty-related, jejunogastrostomy in, 82, 83 myotomy technique in, 137–138 115 jejunojejunostomy in, 82 operative strategy in, 134 prevention of, 115–116 mobilization of jejunum graft in, 82 operative technique in, 134–138 Hepatic arteries pyloromyotomy in, 83 postoperative care following, left pyloroplasty in, 83 138 division of, 85 resection of diseased esophagus preoperative preparation for, posterior gastropexy-related in, 81–82 134 injury to, 107 Stamm gastrostomy in, 82 Heller, as achalasia treatment, left accessory 10–11 in esophagogastrectomy, 42, 45 K in transthoracic gastroplasty, Kocher maneuver N 118, 120 in duodenojejunostomy Roux-en-Y Neck replaced, 100 switch operation, 131 dissection of, in transhiatal Hepatic vein, Nissen fundoplication- in esophagectomy, 20–21, 22 esophagectomy, 67 related injury to, 85 in esophagogastrectomy with left esophageal diversion in, 153–154 Hernia thoracoabdominal approach, esophagogastric reconstruction in, diaphragmatic, esophagomyotomy- 45, 46 29–21 related, 143 in transhiatal esophagectomy, 67 perforations of, 150 hiatal, 4–5 Kyphoscoliosis, paraesophageal hiatal Nissen fundoplication incarcerated, 5 hernia-related, 4 definition of, 6 paraesophageal, 4, 5, 7 with esophageal anastomosis, 27 posttraumatic, 4–5 L end-to-side anastomosis, 55 repair of, 85 , for hiatal hernia-related in esophagogastrectomy with left sliding, 4, 5–6 gastroesophageal reflux thoracoabdominal approach, Hill repair. See Gastropexy, posterior treatment, 5–6 36, 55 (Hill repair) Latissimus dorsi muscle, division of laparoscopic, 95–106 Hydropneumothorax, esophageal in esophagogastrectomy, 37–38 complications of, 95, 106 perforation-related, 9 in transthoracic gastroplasty, 116 creation of the wrap in, 95, Hypaque swallow, 106 105–106 Hypotension, transhiatal M dissection of the hiatus in, 96, esophagectomy-related, 66 Manometry, esophageal 98–100 for esophagocardiac junction exposure of the hiatus in, 95, 96, I pressure measurement, 108 97 Instruments, as esophageal for gastroesophageal reflux identification of the esophagus perforation cause, 9 evaluation, 5 in, 98 162 Index

Nissen fundoplication (cont.) Pneumothorax S indications for, 95 esophageal perforation-related, Scissors, Metzenbaum, 21, 38, 108 mobilization of the esophagus 9 Sepsis in, 95, 100–102 tension esophageal perforation repair- operating room setup for, 95–96 laparoscopic Nissen related, 155 operative strategy in, 95 fundoplication-related, esophagogastrectomy-related, 36 operative technique in, 95–106 95 Short gastric vessels, division of patient positioning in, 95–96 transhiatal esophagectomy- in Nissen fundoplication, 95, 102, pitfalls and dangers in, 95 related, 68 103–105 postoperative care following, Proton pump inhibitors, 5, 6 in transthoracic gastroplasty, 121 106 Pseudoachalasia, 11 , herniation of, Nissen preoperative preparation for, 95 Pulmonary complications, of fundoplication-related, 95, short gastric vessel division in, esophagectomy, 33 102 95, 102, 103–105 Pyloromyotomy Spasms, esophageal, diffuse, trocar placement in, 96 in esophagectomy, 21–23 esophagomyotomy for, 139, transabdominal, 85–94 in esophagogastrectomy with 143 abdominal closure in, 93 left thoracoabdominal Spleen, intraoperative injury to antireflux valve testing in, 92–93 approach, 45 laparoscopic Nissen complications of, 85, 86, 93 in jejunum interposition, 83 fundoplication-related, 95 gastric fundus mobilization in, in long segment colon posterior gastropexy-related, 107, 85 interposition, 77 110–111 hiatal defect repair in, 91 in transhiatal esophagectomy, 67, transabdominal Nissen incision in, 87 70 fundoplication-related, 85–86 indications for, 85 Pyloroplasty, in jejunum transhiatal esophagectomy-related, length of the fundoplication, 86, interposition, 83 66 92 transthoracic gastroplasty-related, mobilization of the esophagus R 115 in, 87–90 Recurrent laryngeal nerve Splenectomy, in mobilization of the gastric cricopharyngeal myotomy-related esophagogastrectomy with fundus in, 85, 87, 90, 91 palsy of, 138 left thoracoabdominal operative strategy for, 85–87 in esophagogastrectomy with left approach, 40, 42 operative technique for, 87–93 thoracoabdominal approach, Sponge-holders, 68 pitfalls and danger points in, 85 52, 53 Stenosis, of anastomosis, 33 postoperative care in, 93 transhiatal esophagectomy- Stomach preoperative preparation for, 85 related injury to, 66–67 decompression of, 154–155 splenic injury prevention in, Retractors herniation of, laparoscopic Nissen 85–86 Army-Navy, 112 fundoplication-related, 95, suture line disruption in, 86 esophageal, 100–102 102 suturing of the fundoplication Finochietto, 17, 23, 50, 116 involvement in paraesophageal in, 91–92 Harrington, 17 hernias, 5 tightness of the fundoplication, liver, 96, 97 laparoscopic Nissen 86, 91–92 Thompson, 17, 85 fundoplication-related injury in transthoracic gastroplasty, 122, Weinberg blade o, 67 to, 95 123, 124, 126 Upper Hand, 85 mobilization of Weinberg, 17 in esophagectomy, 17–20 P Roux-en-Y reconstructions in esophagogastrectomy, 42–45 Palliative treatment, of unresectable in bile diversion operations, 7, in esophagogastrectomy with esophageal carcinoma, 2 127, 128 left thoracoabdominal Pancreatitis, hemorrhagic, 34 duodenojejunostomy switch approach, 42–45 Pedicle flaps, in esophageal operation, 131–132 in transthoracic gastroplasty, perforation repair, 151 following esophagogastrectomy, 115 Penrose drains, 68–69 128–129, 130 transection of, in pH, esophageal, 5 following failed antireflux esophagogastrectomy, 45–48 Phrenoesophageal ligaments, operations, 127 volvulus of, 5 division of, 108, 109 with vagotomy and antrectomy, Stomach cancer, Pledgets, Teflon, 92 128 esophagogastrectomy Pleural flap repair, of thoracic as delayed gastric emptying cause, treatment of, 34–65 esophageal perforation, 7 Stomach interposition, in esophageal 150–152 esophagojejunosomy, 1 replacement, 3 Index 163

Strictures, esophageal Trachea, membranous, transhiatal in transabdominal Nissen cervical leaks-related, 2 esophagectomy-related fundoplication, 87, 90 dilation of, during transthoracic laceration of, 66 Vena cava gastroplasty, 120–121 posterior gastropexy-related injury gastroesophageal reflux-related, V to, 107 6–7 Vagotomy transabdominal Nissen surgical treatment of, 6–7 in bile diversion procedures, 127, 128 fundoplication-related injury with colon or jejunum in esophageal replacement, 3, 4 to, 85 interpositions, 73–83 inadvertent, transthoracic Venous compression, with esophagogastrectomy, gastroplasty-related, 115 esophagectomy-related, 13 34–65 Vagus nerves Volvulus, gastric, 5 with transhiatal esophagectomy, anterior, 98 Vomiting, as thoracic esophageal 66–71 in esophageal perforation repair, perforation cause, 9 Surgical legacy techniques 153, 154 esophageal anastomosis stapling in esophagogastrectomy with left Y technique, 52, 54–58 thoracoabdominal approach, Yeast, esophageal content of, 8 posterior gastropexy (Hill repair), 40, 41 107–114 hepatic branch of, in Z transabdominal Nissen Zenker’s (pharyngoesophageal) T fundoplication, 85 diverticulum, cricopharyngeal Thoracic duct, transhiatal left myotomy and operation for, esophagectomy-related injury division of, 67 134–138 to, 66 in esophagogastrectomy, 45 closure of, 138 Thoracotomy, right in posterior gastropexy (Hill complications of, 138 for azygos vein trauma-related repair), 108 dissection technique in, 136–137 hemorrhage control, 67 in transabdominal Nissen incision and exposure in, 134–136 with esophagectomy, 13–33 fundoplication, 87, 90 myotomy technique in, 137–138 in gastric cardia carcinoma, 1 right operative strategy in, 134 in midthoracic esophageal division of, 67 operative technique in, 134–138 carcinoma resection, 1–2 in posterior gastropexy (Hill postoperative care folowing, 138 Total parenteral nutrition, 155 repair), 108 preoperative preparation for, 134