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Stay sutures were placed in the edge of the diaphragm where the hiatus had been resected. The diaphragm was opened anteriorly another 3 cm to allow easy passage of the tumor and stomach into the chest.
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A longitudinal pyloromyotomy was made down to submucosa and the muscle layers were closed longitudinally (Heineke-Mikulicz, see upper GI bleed) to prevent gastric emptying problems post-op.
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