Esophageal carcinoma is known to have a good network of submucosal lymphatics and hence difuse metastatsis.
Three field esophagectomy removes lymphnodes from neck, medaistinum and abdomen
Among patients with upper thoracic cancer, the rates of nodal metastasis were 42.3% in the cervical nodes, 63.1% in the mediastinal nodes, and 19% in the abdominal nodes. The respective rates were 27.5%, 55.8%, and 41% among patients with middle thoracic cancer, and 10.9%, 43.5%, and 67.4% among patients with lower thoracic cancer.
Neck
Incision --- Low collar
The strap muscles and the medial heads of the sternocleidomastoid are divided.
The nodes posterior and lateral to the carotid sheath are removed along with the supraclavicular nodes.
The dissection is limited superiorly by the inferior belly of the omohyoid.
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