Radial drainage patterns develop surrounding areas of high topography where elevation drops from a central high area to surrounding low areas. Rectangular drainage patterns develop where linear zones of weakness, such as joints or faults cause the streams to cut down along the weak areas in the rock.
Surgery to remove some or most of the esophagus is called an esophagectomy. Often a small part of the stomach is removed as well. The upper part of the esophagus is then connected to the remaining part of the stomach.Part of the stomach is pulled up into the chest or neck to become the new esophagus.pen esophagectomy: Many different approaches can be used to remove part of the esophagus. 1  For a transthoracic esophagectomy, the esophagus is removed with the main incisions in the abdomen and the chest. 2  If the main incisions are in the abdomen and neck, it is called a transhiatal esophagectomy.
Gastroesophageal reflux disease is extremely common in North America. The majority of these patients will have a simple type I hiatus hernia. The approach to this repair is usually by laparoscopic Nissen fundoplication. Much less frequently patients will present with a giant paraesophageal hernia (GPEH) (Figure 1). This type of hernia likely results from progression of a simple type I hernia with rolling of the fundus up alongside the gastroesophageal junction.