Our Summary

This research paper looked at the results of a specific kind of surgery, called an esophagectomy (removal of part or all of the esophagus), and compared how well patients did after the surgery depending on whether it was done by a general surgeon or a thoracic surgeon (one who specializes in chest surgeries).

The researchers used data from the American College of Surgeons for surgeries done between 2016 and 2017. They looked at over 1,600 cases and found that just over half were done by thoracic surgeons. They noticed that the type of surgeon didn’t change much about the patient’s characteristics (like age, sex, body mass index, or other health conditions), except for race.

The study found that thoracic surgeons were more likely to use an open approach (a larger incision), and their surgeries were about 30 minutes quicker. However, general surgeons had to redo the surgery less often and were more likely to treat a common complication called a postoperative leak in a different way.

In conclusion, the study found that the outcomes of the surgery were about the same, regardless of whether it was done by a general surgeon or a thoracic surgeon. This suggests that both types of surgeons can effectively perform this surgery.

FAQs

  1. What is an esophagectomy and who can perform this surgery?
  2. What differences were found between esophagectomies performed by general surgeons and thoracic surgeons?
  3. Did the type of surgeon affect the overall outcome of the esophagectomy?

Doctor’s Tip

A helpful tip a doctor might tell a patient about esophagectomy is to discuss with your surgeon the specific approach they will be taking during the surgery (open vs minimally invasive) and any potential complications that may arise. It is important to have a clear understanding of the procedure and what to expect post-surgery in order to make informed decisions about your care. Additionally, following your surgeon’s post-operative care instructions and attending all follow-up appointments will help ensure a successful recovery.

Suitable For

Patients who are typically recommended for esophagectomy are those with esophageal cancer, Barrett’s esophagus, severe esophageal dysplasia, esophageal strictures, or other conditions that affect the esophagus. These patients may have tried other treatments that have not been successful, or their condition may be too advanced to be treated with less invasive methods. Esophagectomy is a major surgery and is typically recommended for patients who are otherwise healthy enough to undergo the procedure and recover successfully.

Timeline

Before the esophagectomy:

  1. Patient is diagnosed with a condition that requires removal of part or all of the esophagus, such as esophageal cancer or Barrett’s esophagus.
  2. Patient undergoes preoperative testing and consultations with healthcare providers to prepare for the surgery.
  3. Patient may undergo chemotherapy or radiation therapy to shrink the tumor before surgery.
  4. Surgery date is scheduled and patient is instructed on preoperative preparations, such as fasting before the surgery.

After the esophagectomy:

  1. Patient undergoes the esophagectomy procedure, which can be performed by either a general surgeon or a thoracic surgeon.
  2. Recovery period in the hospital, which can range from several days to weeks, depending on the extent of the surgery and any complications.
  3. Patient may experience side effects such as difficulty swallowing, weight loss, and changes in diet.
  4. Follow-up appointments with the surgeon and other healthcare providers to monitor recovery and address any complications.
  5. Patient may undergo additional treatments, such as chemotherapy or radiation therapy, depending on the underlying condition.
  6. Long-term follow-up to monitor for recurrence of the condition and overall health.

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 an esophagectomy?
  2. How many esophagectomy surgeries have you performed, and what is your success rate?
  3. What is your approach to managing postoperative complications, such as leaks?
  4. What type of incision do you typically use for an esophagectomy, and why?
  5. How long is the recovery process expected to be, and what can I expect in terms of pain management and rehabilitation?
  6. Are there any alternative treatment options to consider before proceeding with an esophagectomy?
  7. What are the long-term implications of having part or all of my esophagus removed?
  8. How will my diet and eating habits be affected after the surgery, and will I need to make any permanent lifestyle changes?
  9. What follow-up care will be necessary after the surgery, and how often will I need to be monitored?
  10. Are there any specific factors about my individual health or medical history that may impact the success of the surgery?

Reference

Authors: Hsu DS, Ely S, Gologorsky RC, Rothenberg KA, Banks KC, Dominguez DA, Chang CK, Velotta JB. Journal: Am Surg. 2023 May;89(5):1546-1553. doi: 10.1177/00031348211065117. Epub 2021 Dec 29. PMID: 34965741