Our Summary

This study aimed to understand if the type of surgeon (general or thoracic) performing esophagectomy (surgery to remove part of the esophagus) for cancer patients affects the outcome. They used data from the American College of Surgeons National Surgical Quality Improvement Project, which included 2657 esophagectomies performed between 2016 and 2019. They found that these surgeries were almost equally performed by general and thoracic surgeons. The type of surgery performed varied, with thoracic surgeons more often performing transthoracic esophagectomy and general surgeons more often using minimally invasive techniques. The study found that the type of surgeon did not affect the patient’s chance of dying within 30 days of surgery or the risk of anastomotic leak (a complication where the joined parts of the esophagus leak). However, surgeries performed by thoracic surgeons were about 40 minutes shorter and had a higher chance of requiring a blood transfusion. This suggests that the type of surgeon doesn’t significantly impact the major outcomes of esophagectomy for cancer patients.

FAQs

  1. Does the type of surgeon performing esophagectomy affect the outcome of the surgery?
  2. What are the main differences between esophagectomies performed by general surgeons and those performed by thoracic surgeons?
  3. Does the type of surgeon affect the patient’s chance of dying within 30 days of surgery or the risk of anastomotic leak?

Doctor’s Tip

A helpful tip a doctor might tell a patient about esophagectomy is to follow post-operative care instructions carefully, including taking medications as prescribed, avoiding heavy lifting or strenuous activity, and attending follow-up appointments to monitor recovery and address any concerns promptly. It is also important to maintain a healthy diet and lifestyle to support healing and reduce the risk of complications.

Suitable For

Patients who are typically recommended esophagectomy include those with esophageal cancer, particularly in cases where the cancer has not spread beyond the esophagus or nearby lymph nodes. Other conditions that may warrant esophagectomy include severe Barrett’s esophagus with high-grade dysplasia, esophageal strictures that cannot be managed with other treatments, and certain types of esophageal motility disorders. Additionally, patients who have not responded to other treatments such as chemotherapy or radiation therapy may also be recommended for esophagectomy.

Timeline

Before esophagectomy:

  • Patient is diagnosed with esophageal cancer
  • Patient undergoes various tests and consultations to determine the best course of treatment
  • Patient may undergo chemotherapy and/or radiation therapy to shrink the tumor before surgery
  • Patient undergoes pre-operative preparations, such as fasting and bowel preparation

After esophagectomy:

  • Patient undergoes the surgical procedure to remove part of the esophagus
  • Patient is monitored closely in the intensive care unit (ICU) for any complications
  • Patient gradually transitions to a liquid diet and then solid foods
  • Patient undergoes physical therapy to regain strength and mobility
  • Patient may experience side effects such as difficulty swallowing, reflux, and weight loss
  • Patient undergoes regular follow-up appointments and tests to monitor for any signs of recurrence or complications.

What to Ask Your Doctor

  1. What are the risks and benefits of esophagectomy for my specific condition?
  2. What type of esophagectomy procedure will be performed (transthoracic, transhiatal, minimally invasive, etc.)?
  3. How experienced is the surgeon in performing esophagectomy procedures?
  4. What is the expected recovery time and what should I expect during the recovery process?
  5. What are the potential complications and how are they typically managed?
  6. Will I need any additional treatments (chemotherapy, radiation therapy) before or after the surgery?
  7. What is the long-term outlook for patients who undergo esophagectomy for cancer?
  8. Are there any lifestyle changes or dietary restrictions I will need to follow after the surgery?
  9. How often will follow-up appointments be needed to monitor my progress?
  10. Are there any clinical trials or newer treatment options that I should consider before proceeding with esophagectomy?

Reference

Authors: Verma A, Hadaya J, Kronen E, Sakowitz S, Chervu N, Bakhtiyar SS, Benharash P. Journal: Surg Endosc. 2023 Nov;37(11):8309-8315. doi: 10.1007/s00464-023-10391-5. Epub 2023 Sep 7. PMID: 37679585