Review
Copyright ©2005 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 21, 2005; 11(15): 2211-2212
Published online Apr 21, 2005. doi: 10.3748/wjg.v11.i15.2211
Surgical resection for esophageal carcinoma: Speaking the language
Robert J. Korst
Robert J. Korst, Division of Thoracic Surgery, Department of Cardiothoracic Surgery, and Department of Genetic Medicine, Weill Medical College of Cornell University, New York, NY, USA
Author contributions: All authors contributed equally to the work.
Correspondence to: Robert J. Korst, MD, Weill Medical College of Cornell University, Room M404, 525 East 68th Street, New York, NY 10021, USA. rjk2002@med.cornell.edu
Telephone: +1-212-7465104 Fax: +1-212-7468426
Received: July 17, 2004
Revised: July 28, 2004
Accepted: July 21, 2004
Published online: April 21, 2005
Abstract

The terminology used to describe esophagectomy for carcinoma can be confusing, even for specialists in gastrointestinal disease. As a result, specific terms are often used out of their intended context. To simplify the nomenclature, two points regarding procedures for surgical resection of the esophagus are critical: the extent of resection (radical vs standard) and the operative approach (choice of incisions). It is important to understand that the radicality of the resection may have little to do with the operative approach, with the exception of esophagectomy without thoracotomy (transhiatal esophagectomy), which mandates the performance of a standard or non-radical resection. Esophagectomy has emerged as the standard curative treatment option for patients with esophageal carcinoma; however, unlike the surgical resection of other types of solid tumors, many different surgical options and/or approaches exist for these patients. This heterogeneity of care may result from the fact that the esophagus is accessible through more than one body cavity (left hemithorax, right hemithorax, abdomen). In addition, and partially as a result of its accessibility, different types of surgical specialists harbor this operation in their armamentarium, including general surgeons, thoracic surgeons, and surgical oncologists. Despite this enthusiasm amongst surgeons, little consensus exists as to which option is most oncologically sound. Further, the details of the various surgical approaches and procedures for resection of the esophagus are often difficult to comprehend, even for specialists in gastrointestinal disease, with much of the relevant terminology used out of its intended context. To facilitate the understanding of the surgical options for esophageal carcinoma, it is useful to view the operation from two angles: the extent of resection (Aradical@ vs Astandard@) and the operative approach (choice of incisions).

Keywords: Esophageal carcinoma; Terminology