Oesophageal cancer: Surgery

Oesophageal surgery remains a challenge for the surgeon despite rapid medical advances in the recent past. The procedures are particularly difficult because of the thoraco-abdominal localization of the oesophagus and its vicinity to vital organs. Although oesophageal operations are usually only carried out in high-volume centres which provide around-the-clock interdisciplinary care, they are still accompanied by a high number of complications. This chapter summarizes the history of oesophageal surgery and provides an overview of the conventional surgical approaches used for oesophageal resections, including transhiatal blunt oesophageal dissection and gastric pull-up, subtotal en bloc oesophagectomy—abdominothoracic approach, abdominothoracic en bloc oesophagectomy with high intrathoracic anastomosis, and limited resection of the gastro-oesophageal junction with isoperistaltic jejunal interposition.