Esophageal resection for high-grade dysplasia and intramucosal carcinoma: When and how?

Table 3 Selecting an appropriate surgical approach

Patient characteristics

Prior surgery (thoracic, abdominal, esophageal)

Obesity

Age

Pulmonary function

Other comorbid factors

Surgical options

Standard open resection

Transhiatal esophagectomy (2 or 3 holes)

Minimally invasive esophagectomy

Vagus sparing esophagectomy

Mucosal stripping esophagectomy?

Extent of operation

Extent of esophageal resection

Limited resection of Barrett’s segment

Near-total esophagectomy

Extent of soft tissue resection

Minimal

Standard

Extended

Extent of nodal dissection

Minimal

Standard

Extended 3-field

Surgical results

Accuracy of staging

Number of lymph nodes

Effects on long-term survival

Effects on perioperative outcomes