Our Summary

This research paper is about a study into the outcomes of esophagectomy surgery (removal of all or part of the esophagus) for benign (non-cancerous) conditions, using data from the National Surgical Quality Improvement Program database. The outcomes of these surgeries were compared to those performed for malignant (cancerous) conditions.

From 2005 to 2015, 7,477 patients had this type of surgery. Most of these operations (6,762) were for cancer, while 715 were for benign conditions. In the benign cases, the esophagus was usually replaced with part of the stomach, but sometimes part of the colon or intestine was used.

The study found that surgery for benign conditions was more likely to be an emergency, patients stayed in the hospital longer, and there were more serious complications compared to surgeries for cancer. However, the death rate was the same for both at 4%.

When part of the colon or intestine was used to replace the esophagus, there were more serious complications, more surgical wound infections, and a higher death rate compared to when part of the stomach was used.

The location of the surgical connection (anastomosis) did not affect the outcomes. The researchers concluded that although esophagectomy for benign conditions has significant risks, the use of the colon or intestine should be carefully considered because of the higher rate of serious complications.

FAQs

  1. What is the difference in outcomes between esophagectomy surgeries for benign and malignant conditions?
  2. What were the common complications observed when the esophagus was replaced with part of the colon or intestine?
  3. Did the location of the surgical connection affect the outcomes of the esophagectomy?

Doctor’s Tip

A helpful tip a doctor might tell a patient about esophagectomy is to carefully consider the type of replacement organ (such as part of the stomach versus part of the colon or intestine) that will be used during the surgery. Using part of the stomach may have lower rates of serious complications and surgical wound infections compared to using part of the colon or intestine. Patients should discuss the potential risks and benefits of each option with their surgeon before making a decision.

Suitable For

Patients who are typically recommended for esophagectomy surgery for benign conditions are those who have tried other treatments and medications that have not been successful in treating their condition. These patients may have conditions such as severe gastroesophageal reflux disease (GERD), strictures (narrowing) in the esophagus, or esophageal motility disorders.

Additionally, patients who are in good overall health and have a lower risk for complications from surgery may be recommended for esophagectomy. It is important for patients to have a thorough evaluation by a medical team, including a gastroenterologist and a surgeon, to determine if esophagectomy is the best treatment option for their specific condition.

Timeline

Before esophagectomy surgery, a patient will typically undergo a series of tests and evaluations to determine the need for surgery and assess their overall health. This may include imaging tests, such as CT scans or endoscopy, as well as blood tests and other diagnostic procedures. The patient will also meet with their surgical team to discuss the procedure, potential risks and benefits, and post-operative care.

After the surgery, the patient will be closely monitored in the hospital for complications such as infection, bleeding, or leakage at the surgical site. They may require a temporary feeding tube to receive nutrition while their esophagus heals. Once discharged from the hospital, the patient will continue to have follow-up appointments with their medical team to monitor their recovery and address any issues that may arise.

Overall, the recovery process from esophagectomy surgery can be lengthy and challenging, but with proper care and support, many patients are able to resume a normal quality of life after surgery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about esophagectomy include:

  1. What are the potential risks and complications associated with esophagectomy for my specific condition?
  2. How many esophagectomy surgeries have you performed, and what is your success rate?
  3. Will I need to undergo any additional tests or procedures before the surgery?
  4. What is the expected recovery time and rehabilitation process after the surgery?
  5. Will I need to make any lifestyle changes or follow a specific diet after the surgery?
  6. What are the chances of the cancer returning after the surgery?
  7. Are there any alternative treatment options available for my condition?
  8. What measures will be taken to minimize the risk of complications during and after the surgery?
  9. How long will I need to stay in the hospital after the surgery?
  10. What is the long-term outlook for patients who undergo esophagectomy for benign conditions?

Reference

Authors: Masabni K, Kandagatla P, Popoff AM, Rubinfeld I, Hammoud Z. Journal: Ann Thorac Surg. 2018 Aug;106(2):368-374. doi: 10.1016/j.athoracsur.2018.03.047. Epub 2018 Apr 22. PMID: 29689236