Is There a Trans-Hiatal Esophagectomy?

The advantage here is that we avoid the morbidity of the thoracotomy, particularly if the leak occurs in the chest. The disadvantage though is that unlike Iverluis esophagectomy, you're not directly visualizing the chest and so the lymph node harvest tends to be smaller. Long-term survival is equal to the trans-hauracic approach. For squamous cell cancer, if you have an R0 resection, you're done. They don't need adjuvant therapy. For adenocarcinoma, generally most people will get it. But if you have a very small low-grade tumor that didn't get knee-alagement therapy,