Our Summary

This research paper studied whether the number of esophagectomies (surgeries to remove part or all of the esophagus) a hospital performs each year affects the number of patients who die after the surgery. They looked at 56 studies, which included data from 385,469 patients.

The researchers found that hospitals which perform more esophagectomies have a lower rate of patient deaths after the surgery. Specifically, they found that hospitals that perform 45 or more esophagectomies per year had a 53% lower risk of patient death compared to hospitals that perform fewer procedures.

They concluded that patients who need an esophagectomy might have a better chance of survival if their surgery is done at a larger hospital that performs this procedure frequently. They suggested that these surgeries should be centralized at high-volume hospitals for better patient safety.

FAQs

  1. What was the main finding of the research study about esophagectomies?
  2. Does the number of esophagectomies a hospital performs each year affect the survival rate of patients?
  3. What did the researchers suggest for better patient safety during esophagectomies?

Doctor’s Tip

A doctor may advise a patient undergoing an esophagectomy to consider having the surgery done at a high-volume hospital that performs at least 45 esophagectomies per year. This can potentially reduce the risk of post-surgery complications and improve overall outcomes. It’s important to discuss this option with your healthcare provider to ensure the best possible care and outcome for your surgery.

Suitable For

Patients who are typically recommended for esophagectomy include those with esophageal cancer, severe Barrett’s esophagus, esophageal strictures, esophageal dysmotility disorders, and other conditions that affect the esophagus. These patients may have tried other treatments that have not been effective or have a high risk of complications if left untreated. Additionally, patients who are in overall good health and able to tolerate the surgery and recovery process are also good candidates for esophagectomy.

Timeline

Before an esophagectomy:

  • Patient experiences symptoms such as difficulty swallowing, chest pain, weight loss, and reflux
  • Patient undergoes various tests such as endoscopy, biopsy, CT scan, and PET scan to diagnose esophageal cancer
  • Patient receives preoperative counseling and preparation for surgery
  • Patient may undergo chemotherapy and/or radiation therapy to shrink the tumor before surgery

After an esophagectomy:

  • Patient undergoes surgery to remove part or all of the esophagus, typically followed by reconstruction of the digestive tract
  • Patient is closely monitored in the intensive care unit (ICU) immediately after surgery
  • Patient may experience complications such as infection, leakage, and difficulty eating and swallowing
  • Patient undergoes rehabilitation and physical therapy to regain strength and function
  • Patient receives follow-up care and monitoring to check for recurrence of cancer

Overall, the process before and after an esophagectomy involves a significant amount of preparation, surgery, and recovery. The study mentioned above highlights the importance of choosing a hospital that performs a high volume of esophagectomies to improve patient outcomes.

What to Ask Your Doctor

Questions a patient should ask their doctor about esophagectomy:

  1. How many esophagectomies does the hospital where I will be having the surgery perform each year?
  2. What is the success rate of esophagectomies at this hospital?
  3. What are the potential risks and complications associated with an esophagectomy?
  4. What is the recovery process like after an esophagectomy?
  5. Will I need any additional treatments or therapies after the surgery?
  6. What is the long-term prognosis after an esophagectomy?
  7. Are there any alternative treatment options to consider?
  8. How experienced is the surgical team performing the esophagectomy?
  9. What steps will be taken to minimize the risk of complications during and after the surgery?
  10. Are there any lifestyle changes or dietary restrictions I should follow post-surgery?

Reference

Authors: Di J, Lu XS, Sun M, Zhao ZM, Zhang CD. Journal: Int J Surg. 2024 May 1;110(5):3021-3029. doi: 10.1097/JS9.0000000000001185. PMID: 38353697