Our Summary

This research aims to understand the connection between complications after esophagectomy (a surgery to remove part or all of the esophagus) and the death rate after the surgery. The study also tries to understand how having other health issues at the same time can affect the death rate. The researchers analyzed data of patients who had this surgery between 2008 to 2017.

They found that around 64% of patients had complications after the surgery, with the death rate being 3.3%. The most serious complications were respiratory distress syndrome, needing to be put back on a ventilator, and kidney failure. They also found that if a patient had to go back into surgery because of a leak where the surgeon had joined the esophagus to the stomach, there was a higher chance of death. But, if the leak was managed without surgery, there was no increased risk of death. Also, having other health issues did not significantly affect the death rate.

This study helps to identify which complications are the most serious (“major”) after esophagectomy and can help in efforts to decrease the death rate after the surgery.

FAQs

  1. What does this research aim to understand about esophagectomy?
  2. What were the most serious complications found in patients after esophagectomy and how did they affect the death rate?
  3. How did having other health issues at the same time affect the death rate after esophagectomy?

Doctor’s Tip

One helpful tip a doctor might give a patient about esophagectomy is to closely follow post-operative care instructions, such as taking prescribed medications, attending follow-up appointments, and following dietary guidelines. It is also important to report any new symptoms or concerns to your healthcare provider promptly to prevent complications and ensure a successful recovery.

Suitable For

Patients who are typically recommended esophagectomy are those with esophageal cancer, Barrett’s esophagus with high-grade dysplasia, or other conditions that affect the esophagus, such as severe gastroesophageal reflux disease (GERD) or esophageal stricture. Patients who have not responded to other treatments or have a high risk of developing complications from their condition may also be recommended for esophagectomy. Additionally, patients who are in good overall health and able to tolerate the surgery and recovery process may be considered for this procedure.

Timeline

Before 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 ensure they are fit for surgery.
  3. Patient undergoes the esophagectomy surgery.
  4. Patient is monitored closely in the post-operative period for any complications.

After esophagectomy:

  1. Patient may experience complications such as respiratory distress syndrome, ventilator dependence, kidney failure, or leaks at the surgical site.
  2. If a leak occurs, the patient may need to undergo additional surgery to fix it.
  3. Patient is closely monitored for any signs of infection, organ failure, or other complications.
  4. Patient undergoes rehabilitation and recovery process to regain strength and function.
  5. Patient may experience long-term complications such as difficulty swallowing, reflux, or nutritional deficiencies.
  6. Patient follows up with healthcare providers for long-term monitoring and management of any ongoing issues.

What to Ask Your Doctor

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

  1. What are the potential complications I may experience after undergoing an esophagectomy?
  2. How does having other health issues at the same time impact the risk of complications and death after the surgery?
  3. What measures will be taken to prevent or manage complications such as respiratory distress syndrome, ventilator use, kidney failure, and leaks at the surgical site?
  4. How often do patients need to go back into surgery due to complications like leaks, and what is the associated risk of death in these cases?
  5. What steps can I take to reduce my risk of complications and improve my chances of a successful recovery after the surgery?
  6. What is the overall death rate associated with esophagectomy, and how does this compare to national averages or benchmarks?
  7. Are there any specific factors about my health or medical history that may increase my risk of complications or death after the surgery?
  8. What post-operative care and follow-up appointments will be necessary to monitor my recovery and address any potential complications?
  9. Are there any alternative treatment options or surgical techniques that could potentially reduce the risk of complications and improve outcomes for me?
  10. How experienced is the surgical team in performing esophagectomies, and what is their track record in terms of patient outcomes and complication rates?

Reference

Authors: Linden PA, Towe CW, Watson TJ, Low DE, Cassivi SD, Grau-Sepulveda M, Worrell SG, Perry Y. Journal: J Gastrointest Surg. 2020 Sep;24(9):1948-1954. doi: 10.1007/s11605-019-04346-2. Epub 2019 Aug 13. PMID: 31410819