Figure 2.

Endoscopic Ivor-Lewis esophagectomy in a patient with mega-esophagus, anastomosis with EST. (A,B) Before surgery, expanded esophageal lumen indicated by esophagogram and tomography; (C) During surgery, more than one firing of linear-stapling device (Echelon 60, Ethicon Endo-Surgery) was needed to transect the expanded esophagus; (D) Six-postoperative day, esophageal contrast barium swallow demonstrated satisfactory anastomotic diameter without leak. Remnant esophagus is as wide as gastric conduit.