Surgical Treatment of Esophageal Cancer

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Surgery for Esophageal Cancer

Surgical treatment of esophageal cancer is usually effective in the early stages of the disease. Esophageal cancer is not among the common cancers, but it is one of the most lethal gastrointestinal cancers. One of the key concerns associated with this cancer is that in the western countries the incidence of esophageal carcinoma has been growing at nearly 10 percent per annum, which is an alarming situation. No other malignancy has such a high rate of annual increase in the number of new cases. Surgery is more appropriate to treat early lesions in this disease when the lymph node spread is not extensive. In some cases, the surgery may yield successful results for even a moderately advanced tumor.

Surgical Options for Esophagectomy

The surgery in case of esophageal cancer may be an open procedure, or a minimally invasive surgery using laparoscopy. One of the frequent and serious problems associated with transthoracic esophagectomy is pulmonary complications for the patient following the surgery. This risk can be minimized by using a radical thoracoscopic approach which is a latest advancement in this field. The other way to minimize the risk of complications is laparoscopic surgery. But the condition is that the surgery must be performed by a highly skilled laparoscopic surgeon who uses advance laparoscopic techniques for minimally invasive results. However, several studies have indicated that there is not any marked difference in the morbidity rates for the patient in case of open surgery or other minimally invasive surgical techniques. The only benefit may be a reduced risk of pulmonary complications with minimally invasive surgery.

Risks and Complications with Surgical Treatment of Esophageal Cancer

Risk is minimal when the esophagectomy is performed at an early stage. But even in more advanced stages of the cancer, the surgery has shown a five year survival rate for as many as 40 percent of the patients. In cases where the cancer has reached Stage III, a similar survival rate is reported in about 25 to 35 percent of the cases. If the surgery is performed at a highly rated referral facility, chances of morbidity are lower than 6 percent now due to superior surgical techniques. There have been considerable advances in optical technologies, which have led to the introduction of minimally invasive surgical techniques for the esophageal cancer using endoscopic devices.

Even though the mortality rate of esophagectomy is low, there are various complications which may occur in up to 50 percent of the cases. Pulmonary complications may occur in 10 to 50 percent patients, cardiac dysrhythmia may occur in about 10 percent patients and anastomotic leak may also occur in about 10 percent of the patients. Average duration of hospitalization following the surgery is about two weeks. The average survival rate of the surgery for a five year period for patients with early stage tumors may be as high as 80 percent.