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Surgical Management of Esophageal Carcinoma

Medical University of South Carolina, Cardiothoracic Surgery, Charleston, South Carolina, USA

Correspondence: Carolyn E. Reed, M.D., Medical University of South Carolina, Cardiothoracic Surgery, 96 Jonathan Lucas Street, Suite 409, P. O. Box 250612, Charleston, South Carolina 29425, USA. Telephone: 843-792-3362; Fax: 843-792-8286; e-mail: reedce{at}musc.edu

Surgical management of esophageal carcinoma is reviewed. The anatomy and biology are briefly mentioned, since these factors mitigate against the success of surgery. Staging, the key to proper treatment allocation and prognosis, is discussed, including the use of endoscopic ultrasonography, positron emission tomography, and thoracoscopy/laparoscopy. Patient selection and preparation for surgery are important considerations. Surgical techniques are then discussed, as are the advantages and disadvantages of various approaches, the morbidity of surgical resection, survival, and quality-of-life issues. Adjuvant treatment strategies (preoperative radiation, induction chemotherapy, induction chemoradiotherapy, and postoperative treatment) are summarized.

Key Words. Surgery • Cancer • Esophagus

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