Which of the following statement(s) is/are true concerning the surgical anatomy of the esophagus?

b.Spontaneous esophageal perforation tends to be associated with leakage into the left chest

A detailed knowledge of the relations of the esophagus is essential for the surgeon to be able to identify the site and significance of lesions seen by indirect studies such as endoscopy, contrast radiography, and CT scanning, as well as the safe performance of surgical procedures. The cervical esophagus is about 5 cm long. It begins at the level of C6 and extends to the lower border of T1, curving slightly to the left in its descent. Consequently, although the surgical approach to this portion of the esophagus may be from either side of the neck through an incision along the anterior border of the sternocleidomastoid muscle, the left side is chosen if possible. Above the level of the tracheal bifurcation, the esophagus moves to the right of the descending aorta. It then moves to the left, passes behind the tracheal bifurcation and the left main bronchus and descends to the diaphragm. In the lower third, the esophagus courses anteriorly and to the left to pass through the diaphragmatic hiatus. The lower esophagus is covered only by a flimsy mediastinal pleura on the left, and it is this portion which is most commonly the site of spontaneous perforation in Boerhaave’s syndrome. In general, the lower esophagus is most easily approached through the left chest, but access to the supra-aortic esophagus is restricted. Thus, a left thoracotomy is most useful for performing procedures involving the lower esophagus. However, access to the entire thoracic esophagus can be obtained only from the right chest. This incision, however, limits access to intraabdominal organs by the position of the liver and therefore normally requires a separate upper abdominal incision. The abdominal esophagus begins as the esophagus enters the abdomen through the diaphragmatic hiatus. It is surrounded by a fibroelastic membrane, the phrenoesophageal ligament which arises from the subdiaphragmatic fascia. The lower limit of the pharyngoesophageal membrane anteriorly is marked by a prominent fat pad, which corresponds to the gastroesophageal junction. The lower esophageal sphincter (LES) is a zone of high pressure 3–5 cm long at the lower end of the esophagus. Although it does not correspond to any macroscopic anatomical structure, its function appears to be related to the microscopic architecture of the muscle fibers.