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Charles J. Yeo, MD; Keith D. Lillemoe, MD; Andrew S. Klein, MD; Michael J. Zinner, MD

Arch Surg. 1988;123(8):1016-1018.

Abstract
• Perforation of esophageal malignancy secondary to instrumentation is an uncommon but catastrophic complication. Esophageal perforation at the site of an obstructing esophageal malignancy precludes simple operative repair and mandates esophageal resection with reestablishment of gastrointestinal tract continuity. In the past the standard surgical approach has involved transthoracic esophageal resection via thoracotomy. We have successfully treated four patients with perforated esophageal neoplasms by transhiatal esophagectomy and cervical esophagogastrostomy, thus avoiding thoracotomy in high-risk patients. We consider transhiatal esophagectomy an advantageous alternative in the management of selected cases of instrumental esophageal perforation adjacent to an esophageal malignancy.

(Arch Surg 1988;123:1016-1018)

Author Affiliations
From the Department of Surgery, The Johns Hopkins Medical Institutions, Baltimore.

Footnotes
Accepted for publication Sept 29, 1987.

Reprint requests to Department of Surgery, Harvey 802, The Johns Hopkins Hospital, 600 N Wolfe St, Baltimore, MD 21205 (Dr Yeo).

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