|
Specialty Procedures:
Esophageal Cancer Procedures
The Different Surgical Approaches:
Transhiatal
Abdominal and cervical (neck) incisions. The connection between the remaining esophagus and the replacement is in the neck.
Left thoracoabdominal
For removal of cancers at or just above the stomach. The connection between the esophagus and stomach is in the left side of the chest.
Ivor-Lewis
Incisions in the right side of the chest and abdomen. This approach is used for lower third cancers and the connection between the esophagus and stomach is made in the right chest.
Three incision technique
Incisions are in the neck, right chest and abdomen. The connection between the esophagus and the replacement is in the neck.
Chemotherapy and Radiation Therapy
Patients who have medical risks that make surgery particularly dangerous can be treated with chemotherapy and radiation therapy to shrink the tumor and improve swallowing. There is some potential for improved survival. Chemotherapy and radiation therapy have been used in experimental programs prior to surgery to try to improve the cure rate.
Palliative Therapy
A variety of techniques are available when the cancers are believed to be unresectable but treatment is needed because of the difficulty swallowing.
Radiation Therapy
Radiation therapy without chemotherapy can improve swallowing in a substantial number of patients.
Dilatation Therapy
Dilatation with a rubber or balloon dilator can provide improved swallowing for a few weeks after which the procedure must be repeated.
Stent Therapy
Placement of rigid plastic or expandable metal tubes (stent) to hold the esophagus open can relieve symptoms of obstruction. Tumor growth between the mesh of the expandable metal stent an occlude the esophagus but can be treated with laser or another stent.
Laser Therapy
A laser light can be administered through an endoscope to "core out" an obstructing cancer of the esophagus. The treatment is effective in most cases but runs a small risk of perforating the esophagus.
Photodynamic Therapy
Chemical agents that make tissue sensitive to light are injected intravenously and taken up by esophageal cancer cells. Light directed through an endoscope results in death of the photosensitized cells. The treatment is complicated by side effects of the drug which causes sunburn to skin exposed to light, nausea and fever.
|
Send Feedback to: 
