Exclusive right thoracic approach for esophagus surgery

An exclusive right thoracic approach for esophagus surgery is rarely used, with few reports of its use in China. We retrospectively reviewed the data of 21 esophageal cancer patients from January 2010 to January 2015. Their age ranged from 74-83 years (average 76.6). All of the patients had lower pulmonary function. After multidisciplinary team discussion, sufficient preoperative preparation, and assessment of cardiopulmonary reserve, an exclusive right thoracic approach for esophageal cancer resection was performed. The esophagus was dissected in the right chest and the stomach was separated through the esophageal hiatus. The tube stomach and the esophageal remnant were anastomosed with a stapling device at the top of the right side of the thoracic cavity. All operations were successfully completed; however, there were two early postoperative deaths resulting from pulmonary infection and pulmonary artery embolism. The one-year postoperative survival rate was 66.7%. An exclusive right thoracic approach could be selectively used for elderly patients with poor pulmonary function.