Esophageal Cancer Surgery: A Comprehensive Guide

Introduction

Esophageal cancer is a very malignant disease of the esophagus (tube connecting the pharynx and stomach). Surgery is usually one of the main treatment modalities, particularly for cancer patients with early or intermediate stages. This manual contains all of the information required for esophageal cancer surgery, including, type, procedure, benefits, risks, cost, and top hospitals.

What is Esophagectomy?

Esophageal cancer surgery involves the removal of a portion or the whole of the esophagus to expose the location of the tumor. Implementation of the procedure may also involve reconstruction of the esophagus based on segments of the stomach or bowel. This is often an integral part of a multipronged approach with chemotherapy and/or radiation therapy.

Why is Esophageal Cancer Surgery Needed? 

For resection of neoplastic masses and cancer metastasis:

• To alleviate symptoms such as difficulty swallowing (dysphagia).
• To improve quality of life by restoring normalcy in eating and digestion, etc.

Types of Esophageal Cancer Surgery

1. Esophagectomy:

• Partial or total removal of the esophagus.
• Often performed when cancer is localized.

2. Minimally Invasive Esophagectomy (MIE): 

• Uses small incisions and advanced tools.
• Enhanced recovery rate and also a reduction of postoperative pain when compared with standard open surgical procedures.

3. Esophagogastrectomy:

• Removes part of the esophagus and stomach.
• Common for cancers near the gastroesophageal junction.

Procedure Steps

1. Preoperative Evaluation:

• Physical exams, imaging (CT scan, PET scan) and biopsies.
• Counseling on diet and recovery expectations.

2. Anesthesia:

• General anesthesia is administered to ensure a painless procedure.

3. Surgery:

• Surgeons remove the affected portion of the esophagus and nearby lymph nodes.
• Reconstruction of the esophagus using stomach or intestine tissues.

4. Postoperative Care:

• Monitoring in the intensive care unit (ICU).
• Nutritional support through feeding tubes.

Benefits of Esophageal Cancer Surgery

• Removes the primary source of cancer.
• Reduces symptoms like swallowing difficulty and weight loss.
• Improves overall survival in combination with other treatments.

Risks and Complications

While the surgery is effective, it carries risks, including:

• Infection or bleeding at the surgical site.
• Leakage from the reconstructed esophagus.
• Breathing difficulties or pneumonia.
• Long-term challenges with swallowing or digestion.

Cost of Esophageal Cancer Surgery in India Compared with the USA

• India: The price is between $4,000 to $8,000 depending on the hospital and the type of procedure.
• USA: Cost of Cost of Esophagectomy (extremely costly, $50,000 to $100,000).

Options for treatment as a standard of care are unparalleled and very much cheaper in India, by the best of national hospitals and dedicated surgeons.

Top Hospitals in India for Esophageal Cancer Surgery

1. All India Institute of Medical Sciences (AIIMS), Delhi
2. Apollo Hospitals, Chennai
3. Tata Memorial Hospital, Mumbai
4. Fortis Memorial Research Institute, Gurgaon
5. Max Super Speciality Hospital, Delhi

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