Our Summary

This research paper investigates whether race affects access to certain types of surgery for esophageal and gastric cancer, and whether it influences post-surgery complications. These types of cancer are significant causes of upper digestive tract malignancies. Minimally invasive surgeries for these cancers generally result in a shorter hospital stay and fewer complications.

The study used data from the American College of Surgeons National Quality Improvement Program for surgeries conducted between 2012 and 2019. The researchers compared the data and found that self-identified black patients were more likely to have open surgery for gastric cancer, as opposed to the minimally invasive method. However, race didn’t appear to influence the type of surgery for esophageal cancer.

Interestingly, black patients were more likely to experience complications, severe complications, and death within 30 days after surgery for esophageal cancer.

The findings suggest that there is a racial disparity in access to minimally invasive gastric cancer surgery and in the occurrence of post-surgery complications for esophageal cancer. The researchers believe these findings merit further examination to remove any obstacles and disparities.

FAQs

  1. Does race affect the type of surgery received for gastric and esophageal cancers?
  2. Are black patients more likely to experience complications or death following esophageal cancer surgery?
  3. Are there disparities in access to minimally invasive gastric cancer surgery based on race?

Doctor’s Tip

A helpful tip a doctor might tell a patient about esophagectomy is to ask about the possibility of undergoing minimally invasive surgery if it is an option for their specific case. Minimally invasive surgery can lead to a shorter hospital stay and fewer complications compared to open surgery. It is important for patients to advocate for themselves and discuss all available options with their healthcare provider to ensure the best possible outcome.

Suitable For

Esophagectomy, a surgical procedure to remove part or all of the esophagus, is typically recommended for patients with esophageal cancer that has not responded to other treatments, such as chemotherapy or radiation therapy. It may also be recommended for patients with Barrett’s esophagus, a condition caused by chronic acid reflux that can lead to esophageal cancer.

Patients who are recommended for esophagectomy may have the following characteristics:

  • Diagnosis of esophageal cancer that is localized to the esophagus
  • Good overall health and physical fitness to tolerate surgery and recover from it
  • No significant medical conditions that would increase the risk of complications during or after surgery
  • Willingness to undergo the extensive recovery process and make lifestyle changes to manage the effects of the surgery, such as changes in diet and eating habits

It is important for patients recommended for esophagectomy to discuss the risks and benefits of the surgery with their healthcare team, including surgeons, oncologists, and gastroenterologists, to make an informed decision about their treatment plan.

Timeline

  • Before esophagectomy:
  1. Patient undergoes various tests and evaluations to determine the extent of the cancer and the best course of treatment.
  2. Patient may undergo chemotherapy and/or radiation therapy to shrink the tumor before surgery.
  3. Patient meets with the surgical team to discuss the procedure, potential risks, and recovery process.
  4. Patient may need to make lifestyle changes, such as quitting smoking or changing their diet, to prepare for surgery.
  • After esophagectomy:
  1. Patient undergoes the surgical procedure to remove part or all of the esophagus, depending on the extent of the cancer.
  2. Patient typically spends several days in the hospital recovering from surgery.
  3. Patient may experience side effects such as difficulty swallowing, reflux, and fatigue.
  4. Patient will need to follow a strict diet and may require physical therapy to regain strength and mobility.
  5. Patient will have regular follow-up appointments with their medical team to monitor their progress and address any concerns.

What to Ask Your Doctor

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

  1. What are the different types of surgeries available for esophageal cancer, and which one do you recommend for me?
  2. What are the benefits and risks of minimally invasive surgery compared to open surgery for esophageal cancer?
  3. How does my race or ethnicity impact the type of surgery I may receive for esophageal cancer?
  4. What steps will be taken to minimize the risk of complications during and after the surgery?
  5. What is the expected recovery time and potential long-term effects of esophagectomy?
  6. How frequently do you perform esophagectomies, and what is your experience and success rate with this procedure?
  7. Are there any alternative treatments or clinical trials that I should consider before proceeding with esophagectomy?
  8. How will you monitor my progress and address any concerns or complications after the surgery?
  9. Will I have access to support services or resources to help me cope with the physical and emotional challenges of esophagectomy?
  10. Are there any lifestyle changes or dietary restrictions I should follow before and after the surgery to improve my outcomes?

Reference

Authors: Haider SF, Ma S, Xia W, Wood KL, Matabele MM, Quinn PL, Merchant AM, Chokshi RJ. Journal: Surg Endosc. 2022 Dec;36(12):9355-9363. doi: 10.1007/s00464-022-09210-0. Epub 2022 Apr 11. PMID: 35411463