Three-field lymphadenectomy for esophageal cancer

Abstract

Lymphatic drainage from the upper two-thirds of the thoracic esophagus occurs mainly towards the neck and upper mediastinum, although there is also some drainage to the nodes along the left gastric artery. In 1981, the first reported study of three-field lymphadenectomy in Japan noted that 10 of 36 patients with esophagectomy had skip metastases to the neck or abdominal lymph nodes in the absence of associated intrathoracic spread. In this chapter, we focus on the lymph node dissection of the upper mediastinal and cervical regions. © 2007 Springer-Verlag Berlin Heidelberg.