Type of Surgery
Information
Last updated: 02/17/2009
Diagnosis
The diagnosis of esophageal cancer begins with a careful history and a review of symptoms, and involves a number of different diagnostic examinations. An esophagoscopy may be performed in the doctor's office, allowing the doctor...
to examine the inside of the esophagus with a lighted telescopic tube (esophagoscope). A barium swallow is another common screening test, performed in the radiology (x ray) department of the hospital or in a private radiology office. In a barium swallow, the patient drinks a small amount of radiopaque (visible on xray) barium that will highlight any raised areas on the wall of the esophagus when chest x-rays are taken. The xray studies will reveal irregular patches that may be early cancer or larger irregular areas that may narrow the esophagus and could represent a more advanced stage of cancer. If either of these conditions is present, the doctors will want to confirm the diagnosis of esophageal cancer; determine how far it has invaded the walls of the esophagus; and whether it has spread to nearby lymph nodes or organs. This staging process is essential in order to determine the best treatment for the patient.
One staging technique is a diagnostic procedure called endoscopic ultrasound. The doctor will thread an endoscope, which is a tiny lighted tube with a small ultrasound probe at its tip, into the patient's mouth and down into the esophagus. This procedure allows the inside of the esophagus to be viewed on a monitor to show how far a tumor has invaded the walls of the esophagus. At the same time, the doctor can perform biopsies of esophageal tissue by cutting and removing small pieces for microscopic examination of the cells for cancer staging. Staging tests may also include computed tomography (CT scans); thorascopic and laparoscopic examinations of the chest and abdomen; and positron emission tomography (PET).
Preparation
The patient will be admitted to the hospital on the day of the operation or the day before, and will be taken to a pre-operative nursing unit. The surgeon and anesthesiologist will visit the patient to describe the resection procedure and answer any questions that the patient may have. The standard preoperative blood and urine tests will be performed. Intravenous lines (IV) will be inserted in the patient's vein for the administration of fluids and pain medications during and after the surgery. Sedatives may be given before the patient is taken to the operating room.
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Other Information
An esophageal resection is the surgical removal of the esophagus, nearby lymph nodes, and sometimes a portion of the stomach. The esophagus is a hollow muscular tube that passes through the chest from the mouth to the stomach—a "foodpipe" that carries food and liquids to the stomach for digestion and nutrition. Removal of the esophagus requires reconnecting the remaining part of the esophagus to the stomach to allow swallowing and the continuing passage of food. Part of the stomach or intestine may be used to make this connection. Several surgical techniques and approaches (ways to enter the body) are used, depending on how much or which part of the esophagus needs to be removed; whether or not part of the stomach will be removed; the patient's overall condition; and the surgeon's preference.
From http://www.surgeryencyclopedia.com/Ce-Fi/Esophageal-Resection.html
Other Information
In 2006, estimates of the direct medical costs of allergic rhinitis in the US ranged from $1.16 billion to $4.5 billion, rising to $7.7 billion when indirect costs were included.
From: AHRQ
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