Extended Total Esophagogastrectomy as Surgical Treatment of Cancer of the Cardia

The first description in medical literature of esophageal dissection performed via the mediastinal route without opening the chest, using a combined cervicoab-dominal approach, was by Levy in 1898 [1], who used a metallic verge in order to facilitate the esophageal dissection. Fifteen years later, Ach, 1913 [2] modified the previous technique, performing the first stripping of the esophagus by means of a rubber tube tied to the proximal end of the esophagus. In the same year, Denk, 1913 [3], to facilitate superficial dissection of an esophagus affected by a malignant tumor, attached a metallic ring to the superior end of a verge which was introduced into the posterior mediastinum through the hiatus. One year later, Rehn and Kleinschmidt [4] proposed a new method of stripping the mucosa and submucosa of the esophagus, dissecting both layers from the surface of the esophageal muscle, which was maintained intact.