Transhiatal esophagectomy.

Transhiatal esophagectomy without thoracotomy was performed on 40 patients with cancer of the esophagus and two with corrosive stricture. The resection and esophagogastric anastomosis in the neck were done in a single stage. The 30-day mortality was 12%. Complications included intraoperative pneumothorax (71%), transient hoarseness (19%), anastomotic leak (17%) and pulmonary complications requiring respiratory assistance (7%). Two patients required surgery for internal hemorrhage, but there was no bleeding from the posterior mediastinum. Short operating time and avoidance of thoracotomy are the clear advantages of this procedure. As experience was gained, mortality and morbidity diminished. Transhiatal esophagectomy is a safe and well-tolerated surgical procedure.