Surgical Approaches to Remove the Esophagus: Vagal-Sparing

Abstract To date no therapy has been proven superior to esophagectomy for the cure of patients with early-stage esophageal cancer. The primary goal of surgery is complete (R0) resection of the tumor in order to maximize the opportunity for cure and minimize the incidence of local recurrence. However, with early-stage disease and a high likelihood of long-term survival, there is an increasing focus on postesophagectomy quality of life, especially since there are endoscopic alternatives for these early lesions. This has prompted us to scale back the extent of the resection and preserve the vagal nerves to try to provide the benefits of complete resection while minimizing some of the morbidity associated with esophagectomy in appropriate candidates.