Figure 4b. McKeown procedure in a 64-year-old man with SCC of the upper thoracic esophagus. (a) CT scan (5-mm section thickness) obtained at the level of the thyroid gland 2 months after surgery shows a cervical esophagogastric anastomosis (arrow). (b) Barium esophagogram obtained 2 months after surgery shows the cervical anastomosis (arrow). Arrowheads indicate a small amount of barium aspirate in the left lower lobe.