Surgery catalogue head, neck
30.06.2011 | PDF | 7.79 KB
The esophagus represents the connection between the Larynx and the stomach and consists of the mucosa as an inner lining and an inner longitudinal as well as an outer transverse muscle layer. When swallowing the esophagus transports the food bolus from the larynx to the stomach. It does so by well coordinated muscle contraction sequences that move from the upper end towards the lower end. Disturbances of this transport function can result in dysphagia up to the complete inability to swallow. Causes are mostly chronic inflammation by reflux, scarring, inborn functional problems or more frequently malignant tumors that cause malignant strictures.
Malignant tumors of the esophagus are mostly derive from the epithelium on the inner surface. We distinguish two forms, the squamous cell cancer and adenocarcinoma. Fuerthermore, for operation planning it is important to know the exact location in the upper, mid or lower third of the esophagus. In tumors of the upper third almost the entie esophagus has to be removed along with the neighboring lymph nodes. In tumors of the mid and lower third the upper part of the esophagus can mostly be preserved. The reconstruction is done gastric pullup to the upper end of the esophagus by formation of a gastric tube. Other techniques can be colon interposition and sometimes even free small bowel loops with autotransplantation to the neck.