Several well described and accepted traditional techniques exist for the performance of an open esophagectomy. The rationale for selecting one of these techniques is determined by the location and histology of the disease being treated and surgeon and institutional preferences. Large retrospective studies and a limited number of prospective studies have comparatively evaluated the operative and long-term oncologic outcomes of transthoracic versus transhiatal surgical approaches, which indicate trends toward higher perioperative complications but improved long-term outcomes among patients treated with a transthoracic approach. Other retrospective studies investigated the extent of a thoracic lympadenectomy that is necessary at the time of an esophagectomy to optimize survival.
