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Surgery of esophageal cancer

Surgical treatment is usually performed with the goal of curing the patient. The treatment is associated with cardiopulmonary complications and with a greater risk for anastomosis leakage than for regular bowel surgery. Poor health status will therefore more often be considered a criterion for inoperability than for other bowel surgery.

Recent studies indicate that using thoracoscopy to remove the thoracic part of the esophagus can reduce the frequency of cardiopulmonary complications. This, however, has not been performed at the Norwegian Radium Hospital, and will not be mentioned further here.

Endoscopic treatment with a sling resection is an alternative to surgery in severe dysplasia and in certain cases of T1 without lymph node metastases. Endoscopic treatment has the advantage of low morbidity and mortality in addition to preserving digestive function. About 50% of these patients, however, do not have the correct stage diagnosis with findings of invasive tumors in the resected material. At treatment centers where these tumors are rare, surgical treatment is the safest alternative.  

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