Our Summary

This research paper looks at how doctors learn to do a newer, less invasive type of surgery for esophageal cancer. The researchers looked at many studies to understand how doctors learn these new techniques. They found that the speed at which doctors learn can affect how well patients do after surgery.

The researchers looked at how long the surgery took, how many lymph nodes were removed, how much the patient was hurt, and how much blood was lost as measures of how well the doctor was learning. They found that doctors seemed to get the hang of the surgery after doing it a certain number of times. For one type of surgery, they needed to do it 7 to 60 times before they got really good. For another type, they needed to do it 12 to 175 times. And for a third type that used a robot to help, they needed to do it 9 to 85 times.

The researchers concluded that we need more research to understand what the best measures of learning are. They also said we need to figure out how many surgeries a doctor should do with a mentor before they are considered fully trained.

FAQs

  1. What factors were considered to measure how well a doctor was learning the new surgical technique?
  2. How many times did doctors need to perform each type of surgery before they were considered proficient?
  3. What were the researchers’ recommendations for future research on this subject?

Doctor’s Tip

A helpful tip a doctor might tell a patient about esophagectomy is to ask their surgeon about their experience with the specific type of surgery being recommended. Patients may want to inquire about the number of times the surgeon has performed the procedure and their success rates. It is important for patients to feel confident in their surgeon’s expertise and experience in order to have the best possible outcome.

Suitable For

Esophagectomy is typically recommended for patients with esophageal cancer that has not spread beyond the esophagus or nearby lymph nodes. Other conditions that may warrant an esophagectomy include severe Barrett’s esophagus, a precancerous condition, or benign esophageal diseases such as refractory strictures or perforations.

Patients who are generally healthy and able to tolerate surgery are considered good candidates for esophagectomy. However, the decision to undergo esophagectomy is complex and requires careful consideration of factors such as the patient’s overall health, stage of cancer, and potential risks and benefits of surgery.

It is important for patients to discuss their individual situation with their healthcare provider to determine if esophagectomy is the most appropriate treatment option for them.

Timeline

Before esophagectomy:

  • Patient is diagnosed with esophageal cancer
  • Patient undergoes various tests and consultations to determine the best treatment plan
  • Patient may undergo chemotherapy and/or radiation therapy to shrink the tumor before surgery
  • Patient receives pre-operative counseling and education about the surgery and recovery process

After esophagectomy:

  • Patient undergoes the surgery to remove part or all of the esophagus
  • Patient may have a hospital stay of 7-14 days or longer depending on the type of surgery and complications
  • Patient may experience pain, difficulty swallowing, and other side effects post-surgery
  • Patient undergoes rehabilitation and physical therapy to regain strength and function
  • Patient undergoes follow-up appointments and monitoring for recurrence of cancer

Overall, the timeline for a patient before and after esophagectomy can vary depending on the individual case and type of surgery performed. Recovery can take several weeks to months, and ongoing monitoring is necessary to ensure the best outcomes.

What to Ask Your Doctor

  1. How many esophagectomy surgeries have you performed?

  2. What type of esophagectomy technique do you use and what are the potential benefits and risks associated with it?

  3. How long does the surgery typically take?

  4. How many lymph nodes do you typically remove during the surgery?

  5. What is your experience with managing post-operative pain for esophagectomy patients?

  6. What is the estimated recovery time and what can I expect during the recovery process?

  7. What is your success rate with this surgery in terms of outcomes and complications?

  8. Do you have a multidisciplinary team in place to support me throughout the surgical process and recovery?

  9. Are there any alternative treatment options to consider before proceeding with esophagectomy?

  10. How many surgeries do you recommend a doctor should perform before they are considered fully trained in this procedure?

Reference

Authors: Prasad P, Wallace L, Navidi M, Phillips AW. Journal: Surgery. 2022 May;171(5):1247-1256. doi: 10.1016/j.surg.2021.10.050. Epub 2021 Nov 28. PMID: 34852934