Minimally invasive surgery helps patients with esophageal cancer

July 14, 2011 By James Flaherty, M.D., FACS, surgical oncologist

Most of us, when we eat or drink, don't really think about swallowing. We just do it. But for some people with esophageal cancer, swallowing even liquids can become difficult or impossible.

With esophageal cancer, cancer cells form in the tissues of the esophagus, the muscular tube that moves food and liquid from our throats to our stomachs. According to the American Cancer Society, men are more likely to have esophageal cancer, with almost 80 percent of it diagnosed between ages 55 and 85. Risk factors include tobacco and alcohol use, obesity, and esophageal inflammatory conditions, most commonly gastroesophageal reflux.

Treatment for esophageal cancer depends on the stage of cancer and other factors, but for many patients, surgery is performed to remove the cancerous part of the esophagus. The surgeon will then connect the healthy part of the esophagus to the stomach, using part of the stomach to create a new tube for swallowing.

Thanks to surgical advances, some surgeons can now perform minimally invasive surgery to remove and reconstruct the esophagus in certain patients. During a procedure called a minimally invasive esophagogastrectomy (MIE), the surgeon makes several 5 mm to 1 cm incisions to the right chest, the upper abdomen and lower neck.

Traditional, open esophagogastrectomy surgery requires a large incision on the side of the chest and another one down the middle of the abdomen. Either procedure is available for patients with cancer up to stage 3.
While not appropriate for all patients, MIE can offer significantly reduced recovery and post-surgical discomfort. Compared to traditional surgery, inpatient hospital stay with MIE is seven to 10 days vs. 10 to 14 days for the open procedure. Recovery time with MIE is two to four weeks vs. up to two to four months.

Whether a patient has an MIE or the traditional surgical procedure, when esophageal cancer is detected early, survival rate after an esophagogastrectomy is about 80 percent at five years. For stages 2 and 3, chemotherapy and radiation therapy often precede surgery and survival at five years ranges from 40 to 60 percent.

James Flaherty, M.D., FACS, specializes in surgical oncology, specifically esophageal cancer surgery, at The Hospital of Central Connecticut. For information on HCC physicians, please contact our free Need-A-Physician referral service by phone, 800.321.6244 or online.