Our Summary

This research paper is a review of patient outcomes after having an esophagectomy (surgery to remove part or all of the esophagus) at Veterans Affairs (VA) hospitals from 2008 to 2019. The study evaluated the relationship between the number of these procedures a hospital performs and the post-surgery results for patients in the first 30 days.

The review found that hospitals performing an average of 4 or more esophagectomies per year had better patient outcomes. Specifically, these hospitals had lower death rates within 30 days after surgery, shorter hospital stays, and longer operating times. The longer operating times could reflect more careful or thorough surgeries, leading to better outcomes.

The study suggests that these better results could be due to more experience and expertise among the surgery teams at hospitals that perform esophagectomies more frequently. The findings could help set a standard for the optimal number of esophagectomies a hospital should perform each year to achieve the best patient outcomes. However, future studies should also look at long-term results after esophagectomy in relation to hospital volume.

FAQs

  1. What is the relationship between the number of esophagectomies a hospital performs and the post-surgery results for patients?
  2. What specific factors were found to improve in hospitals that perform an average of 4 or more esophagectomies per year?
  3. Why do hospitals with more frequent esophagectomies have better patient outcomes according to the study?

Doctor’s Tip

A helpful tip a doctor might tell a patient about esophagectomy is to choose a hospital that performs a higher number of these procedures per year. This can potentially lead to better outcomes and a lower risk of complications. It is important to discuss this with your healthcare provider when considering surgery for esophageal cancer or other conditions requiring an esophagectomy.

Suitable For

Patients who may be recommended for esophagectomy typically include those with esophageal cancer, Barrett’s esophagus with high-grade dysplasia, severe gastroesophageal reflux disease (GERD) that does not respond to other treatments, or esophageal strictures that cannot be treated with other interventions. Additionally, patients with esophageal motility disorders or benign tumors of the esophagus may also be candidates for esophagectomy.

It is important for patients to be evaluated by a multidisciplinary team of healthcare professionals, including surgeons, oncologists, gastroenterologists, and nutritionists, to determine if esophagectomy is the best treatment option for their specific condition. Factors such as the stage of the disease, overall health of the patient, and potential risks and benefits of surgery must be carefully considered before recommending esophagectomy.

Timeline

Before the esophagectomy:

  1. Patient is diagnosed with a condition that requires removal of part or all of the esophagus.
  2. Patient undergoes pre-operative tests and evaluations to assess their overall health and suitability for surgery.
  3. Patient receives counseling on the procedure, risks, and post-operative care.
  4. Patient may need to make dietary and lifestyle changes in preparation for surgery.

After the esophagectomy:

  1. Patient undergoes the surgery to remove part or all of the esophagus.
  2. Patient is closely monitored in the immediate post-operative period for any complications.
  3. Patient may require a short stay in the intensive care unit (ICU) for close monitoring.
  4. Patient gradually starts to eat and drink again, with guidance from healthcare providers.
  5. Patient undergoes rehabilitation and physical therapy to regain strength and function.
  6. Patient is monitored for any long-term complications or side effects of the surgery.

What to Ask Your Doctor

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

  1. How many esophagectomies does the hospital perform each year?
  2. What is the success rate of esophagectomies at this hospital?
  3. How experienced is the surgical team in performing esophagectomies?
  4. What are the potential risks and complications associated with esophagectomy?
  5. What is the expected recovery time after esophagectomy?
  6. Are there any alternative treatment options to consider?
  7. Will I need any additional treatments or therapies after the surgery?
  8. How will my quality of life be impacted after having an esophagectomy?
  9. What support services are available for patients undergoing esophagectomy?
  10. Are there any lifestyle changes I should make before or after the surgery to improve my outcomes?

Reference

Authors: Holleran TJ, Napolitano MA, Sparks AD, Antevil JL, Brody FJ, Trachiotis GD. Journal: J Surg Res. 2022 Jul;275:291-299. doi: 10.1016/j.jss.2022.02.015. Epub 2022 Mar 18. PMID: 35313138