Cancer of the esophagus. All cancers are awful but this one in particular. Untreated it’s quickly lethal. Since retirement I’ve dwelt on this surgical challenge as little as possible; however, my attention was drawn back by a recent letter from someone reading my blogs. He had his esophagus removed by Read More
Category: Esophageal Cancer
It seems time to revisit this topic. Barrett’s esophagus picked up its name years ago when the surgeon Norman Barrett in England performed an esophagectomy on a patient with an ulcer in the esophagus. The final pathologic exam of the esophagus showed that the cells lining the inside of the Read More
The esophagus is located in the body in a way that complicates surgical access. This tubular organ originates in the neck, passes down into the chest where it lurks behind the heart and is crossed over by the aorta as it courses from right to left when leaving the heart, Read More
When I began my thoracic surgery practice in 1981 the prognosis for patients with esophageal cancer was worse than grim. It was a death sentence. The 10-year survival rate was close to zero. Happily, things have changed and outcomes are better. The SEER database now reports 10-year survival for new Read More
This guest blog was written by Mark K. Ferguson, MD. Mark and I were colleagues at the University of Chicago where Adams and Phemister performed the first transthoracic esophagectomy with reconstruction. He has led the Thoracic Surgery division for many years and is an accomplished esophageal surgeon. ~ The average Read More
Considerations in choosing a surgeon. Operations for esophageal cancer are performed by general thoracic surgeons like me (so you know my prejudice), surgical oncologists and general surgeons. Who should operate on you? Appropriate considerations will resemble my previous thoughts for lung cancer surgery. The experience the surgeon had in Read More
Making life better. Not all cancers are curable. When this is the case subjecting the patient to a major operation such as an esophagectomy with its risks of significant morbidity and even mortality is inappropriate. Happily, there are interventions that can improve the quality of life and extend it. Both Read More
What is the goal of an esophagectomy? The answer may seem obvious, but it was not always so. As recently as when I began my practice in the early 1980s the hoped-for outcome was that the patient’s dysphagia would be relieved. Cure of the cancer was a welcome result but Read More
Progress is made. Despite Torek’s “successful” esophagectomy discussed in the previous blog, few such operations were subsequently performed. In 1933 the British surgeon Grey-Turner introduced an alternative technique for esophagectomy. He made incisions in the neck and abdomen and, sliding his hands down and up respectively, freed and removed the Read More
Into the chest. The chest is the home of most of the esophagus, so it is the location of most cancers. Operating in the chest was impossible until sufficient anesthesia capabilities were established and the lungs could be ventilated. No awake and sentient patient could tolerate the pain of a Read More
