Fig. 5

Schematic illustrations of the two-stage operation. a Subtotal esophagectomy was performed in the first stage operation with the combination of transcervical and transhiatal approaches. Dashed arrow, cervical skin incision; double lines, oral and anal margins of the esophagectomy; black dot, the location of the esophageal perforation. b Status after the first stage operation. Cervical esophagostomy was placed in the left side of the patient’s neck and a 19-Fr drainage tube (dotted thick line) was placed via the left side of the patient’s neck into the upper mediastinum. c Status after the second stage operation. Gastric conduit was lifted via a subcutaneous route, and an esophago-gastric anastomosis was performed. A 19-Fr drainage tube (dotted thick line) was placed behind the anastomosis via the left side of the patient’s neck