09/05/2024

Prof. Riccardo Rosati - Ivor Lewis esophagectomy

Ivor Lewis esophagectomy is a two-phase technique (abdominal and thoracic) indicated for mid to distal esophageal and junctional cancers. The abdominal phase includes the complete mobilization of the stomach and the creation of a gastric tube with careful preservation of the right gastroepiploic arcade. The subsequent thoracic phase consists of completing the esophageal dissection in the mediastinum and perfoming the esophagogastric anastomosis at the apex of the chest. Additionally, the procedure includes an adequate lymphadenectomy with a variable extent depending on the type and location of the tumor. This technique can be performed using different approaches, but in the last decades, the minimally invasive approach has progressively become the preferred one. Despite requiring high surgical expertise, it has been shown to reduce the incidence of postoperative pulmonary complications and enhance postoperative recovery.