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Thoracic Surgery and Esophagectomy

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Oncologic Critical Care

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Abstract

Esophageal cancer is ranked sixth in mortality and classified as the eighth most common cause of cancer [30]. It is classified by two main histological types squamous-cell carcinoma and adenocarcinoma. Both types of malignancy differ in regard to incidence, etiology, risk factors, and population affected. Esophageal squamous-cell carcinoma has been associated with smoking, heavy alcohol use, red meat consumption, hot beverage drinking, poor oral health, low intake of fresh fruits and vegetables, and low socioeconomic status. Obesity, gastroesophageal reflux disease, and Barrett’s esophagus have been recognized as high-risk factors for adenocarcinoma of the esophagus. There are several conditions and lesions that are considered premalignant and may lead to the development of esophageal carcinoma.

Esophageal cancer is typically three to four times more common among males than in females and slightly deadlier in men than women. The most common presenting symptom in esophageal cancer is dysphagia. The majority of patients do not present with premalignant or early-stage disease but with advanced locoregional and metastatic disease. Proper histopathological diagnosis and staging are crucial in determining the adequate management of patients with esophageal cancer. There are a wide variety and combination of treatments including chemotherapy, radiation, endoscopic procedures, and surgery. Major morbidity after esophagectomy can be up to 65%. Anastomotic leak and pulmonary complications are among the most reported complications. Esophagogastric anastomotic leak accounts for 40% of postoperative fatalities after esophagectomy. The incidence is 4–17%, and the etiology is multifactorial. The 5-year survival rate for patients able to undergo resection is 47%.

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Author information

Authors and Affiliations

  1. Department of Anesthesiology and Perioperative Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA

    Melissa Morris Puskac

  2. Department of Thoracic and Cardiovascular Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA

    Robert A. Hetz

Authors
  1. Melissa Morris Puskac
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  2. Robert A. Hetz
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Editor information

Editors and Affiliations

  1. Department of Critical Care and Respiratory Care, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Joseph L. Nates

  2. Division of Anesthesiology, Critical Care and Pain Medicine, Department of Critical Care and Respiratory Care, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Kristen J. Price

Section Editor information

  1. Department of Anesthesiology Division of Anesthesia, Critical Care and Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Garry Brydges DNP, MBA, CRNA, ACNP-BC, FAAN

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Puskac, M.M., Hetz, R.A. (2020). Thoracic Surgery and Esophagectomy. In: Nates, J., Price, K. (eds) Oncologic Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-319-74588-6_166

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  • DOI: https://doi.org/10.1007/978-3-319-74588-6_166

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-74587-9

  • Online ISBN: 978-3-319-74588-6

  • eBook Packages: MedicineReference Module Medicine

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