Surgical treatments for esophageal cancers

Abstract

The following, from the 12th OESO World Conference: Cancers of the Esophagus, includes commentaries on the role of the nurse in preparation of esophageal resection (ER); the management of patients who develop high-grade dysplasia after having undergone Nissen fundoplication; the trajectory of care for the patient with esophageal cancer; the influence of the site of tumor in the choice of treatment; the best location for esophagogastrostomy; management of chylous leak after esophagectomy; the optimal approach to manage thoracic esophageal leak after esophagectomy; the choice for operational approach in surgery of cardioesophageal crossing; the advantages of robot esophagectomy; the place of open esophagectomy; the advantages of esophagectomy compared to definitive chemoradiotherapy; the pathologist report in the resected specimen; the best way to manage patients with unsuspected positive microscopic margin after ER; enhanced recovery after surgery for ER: expedited care protocols; and long-term quality of life in patients following esophagectomy.

Keywords: Nissen fundoplication; OESO; chemoradiotherapy; esophageal resection; esophagectomy; esophagogastrostomy.

Figure 1

Surgical algorithm for esophageal cancers.

Figure 2

Postoperative nutritional strategy of avoiding early oral feeding.

Figure 3

Endoscopic control of anastomosis (indicated by the arrow) during the operation.

Figure 4

Contrasting imagining of the anastomosis. The anastomosis is indicated by the arrow.

Figure 5

(A) Patient A: proximal cervical esophageal margin (inked blue) with tumor foci present within the muscle wall. (B) Patient B: mucinous signet ring adenocarcinoma consisting of mucin pools with scattered rare viable carcinoma cells involving the distal stomach resection margin.