Video-assisted endoscopic esophagectomy with stapled intrathoracic esophagogastric anastomosis.

Thoracic esophagus was usually removed through the transhiatal approach or via an open thoracotomy. The long incision and spreading of the ribs usually resulted in much pain and interference with chest wall mechanics. Today, with the development of a video-assisted endoscopic procedure, many intrathoracic lesions can be removed through small incision. Since March 1992 we have attempted 20 esophagectomies and reconstruction using a right thoracoscopic approach in 16 males and 4 females whose average age was 56 years. Indications for its use were esophageal cancer in 17 patients (squamous cell carcinoma in 12 patients, adenocarcinoma in 5) and caustic stenosis in 3. It is our impression that video-assisted endoscopic esophagectomy and reconstruction potentially causes less trauma, less postoperative discomfort, and a rapid functional recuperation. Our initial experiences showed that it is a feasible, effective procedure.