Surgery for Esophageal Cancer

Minimally Invasive Approach

At Scott & White, the majority of operations are performed with minimally invasive techniques. Benefits of minimally invasive surgery include:

  • Better cosmetic result
  • Quicker recovery times, allowing you to:
    • Return to your daily routine sooner
    • Begin future treatment sooner
  • Shorter hospital stay
  • Less pain
  • Less blood loss
  • Lower risk of infection
  • Fewer complications

Not all patients are candidates for a minimally invasive approach. Factors affecting the decision to use minimally invasive techniques include:

  • Tumor size, stage or location
  • Patient obesity and health
  • Prior surgeries

The surgical treatment of esophageal cancer requires expertise in both GI surgery and thoracic surgery, as this malignancy involves both GI and pulmonary systems. We offer fully minimally invasive, hybrid and traditional open procedures, depending on the specifics of each patient and tumor. We customize the approach to each unique patient.

Scott I. Reznik, MD, Chief – General Thoracic Surgery

Your physician team may recommend the surgical removal of all or part of your esophagus. The team may recommend other treatments in addition to surgery. At Scott & White, we use minimally invasive techniques whenever possible and appropriate, based on your condition.

Surgical Approaches and Procedures

Your operation may be performed by any one of the following methods:

  • Laparoscopy
  • Thoracoscopy
  • Endoscopy
  • Open surgery

Your surgeon will discuss which approach is best for you as well as any risks involved.

At Scott & White, treatment goals for esophageal cancer generally are centered on preserving GI-tract function and preventing distant and local symptoms and recurrence.

Endoscopic Mucosal Resection

In this procedure, your surgeon will make several small incisions in your chest and insert an endoscope (a very small high-definition camera attached to a thin tube). Using the endoscope and surgical instruments, your surgeon will remove the inner lining of your esophagus. This treatment is often used for dysplasia (pre-cancer), as well as for small tumors.

Esophagectomy

In this surgical procedure, your thoracic surgical oncologist will remove your tumor, adjacent lymph nodes and the affected part of your esophagus in a partial esophagectomy. Your surgeon will then reconnect the remaining esophagus to the stomach or intestine.

In a total esophagectomy, your thoracic surgical oncologist will remove your tumor, adjacent lymph nodes and your entire esophagus. Your surgeon will reconstruct an esophagus from parts of your stomach, colon or small intestine.

Special Note Regarding Esophagectomies

Operations to remove all or part of your esophagus are highly complex, requiring the expert skill of our experienced thoracic surgical oncologists and our GI Cancer Team.

You will stay in the hospital a week or more and need several months of recovery at home. In some cases, your physician may recommend in-patient rehabilitation.

Following your operation, your physician may recommend occupational therapy or physical therapy for assistance with:

  • Walking
  • Eating

There is a possibility you may have damage to your vocal cords. If so, you may need speech-language therapy as well.

Esophageal Stent Placement

In some cases, your surgeon may place a plastic or metal tube (stent) in your esophagus, opening your esophagus, thereby allowing you to swallow more comfortably. The stent may be permanent or temporary.

In some cases, your physician team may recommend a feeding tube prior to your surgery or other therapy in order to improve your nutritional status.

Esophageal Ablation / Radiofrequency Ablation (RFA)

In this procedure, high-powered energy is directed at the tumor site to kill any abnormal cells. This treatment is often used for dysplasia (pre-cancer) and Barrett’s esophagus.

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Palliative Surgery

Your comfort and quality of life is paramount at Scott & White. Our thoracic surgical oncologists and gastroenterologists are committed to ensuring that you’re as pain-free and comfortable as possible, if your esophageal cancer advances.

Here are the procedures offered to help relieve symptoms associated with advanced esophageal cancer.

Endoscopic Dilatation of the Esophagus

In this procedure, your surgeon will open up your esophagus using a very small high-definition camera attached to a thin tube (endoscope) and a balloon-type or other device, allowing you to swallow more normally.

Esophageal Stent Placement

In this procedure, your surgeon will place a plastic or metal tube (stent) in your esophagus, opening your esophagus, thereby allowing you to swallow more normally. The stent may be permanent or temporary.

Percutaneous Gastrostomy

In this procedure, your surgeon will insert a feeding tube directly into your stomach or intestine so that you may receive nutrition to maintain weight and strength. The feeding tube may be permanent or temporary.

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