Hailey Tran
Cleveland Clinic offers esophageal cancer surgery, also known as esophagectomy, which involves removing all or part of the patient's esophagus. The procedure is often extensive, requiring the removal of damaged tissue and the reconstruction of the digestive system. Cleveland Clinic's Department of Thoracic Surgery is recognized for its expertise and leadership in treating diseases of the lung and esophagus, including esophageal cancer. The center has earned a three-star rating from the Society of Thoracic Surgeons (STS) for its patient care and outcomes in esophagectomy, placing it among the elite for general thoracic surgery in North America. Additionally, the UH Cleveland Medical Center is ranked in the top 10% of all major academic hospitals in the nation for reduced mortality and morbidity following esophageal surgery.
| Characteristics | Values |
|---|---|
| Hospital Name | UH Cleveland Medical Center, Cleveland Clinic |
| Surgical Expertise | Esophagectomy, Endoscopic Mucosal Resection (EMR), Endoscopic Submucosal Dissection (ESD), Minimally Invasive Surgery, Laparoscopic Surgery |
| Cancer Treatment | Esophageal Cancer, Lung Cancer, Precancerous Lesions of the Esophagus, Thoracic Surgery |
| Team | Oncologists, Gastroenterologists, Surgeons, Nurses, Dietitians, Social Workers, Pain Management Specialists |
| Mortality Rate | Perioperative Mortality: 0.7% vs. 3.5% Academic Hospital Benchmark |
| Length of Stay | Median: 7 days vs. 10 days Academic Hospital Benchmark |
| Rating | Three-star rating from The Society of Thoracic Surgeons (STS) |
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What You'll Learn
Cleveland Clinic's Esophageal Cancer Program
The clinic's surgical team has extensive experience in treating esophageal cancer, having performed over 1,000 esophagectomy procedures since 2000. Esophagectomy is a surgery that involves removing all or part of the oesophagus, the tube that carries food and liquid from the throat to the stomach. This procedure is often necessary for esophageal cancer patients to ensure they can eat and swallow properly. Cleveland Clinic surgeons are skilled in both traditional open surgery and minimally invasive techniques, such as laparoscopic surgery, for esophagectomies.
The clinic's thoracic surgery department is recognised as a leader in the surgical treatment of diseases involving the chest, airway, and esophagus. They offer cutting-edge screening techniques and advanced minimally invasive procedures. The department serves as a national referral centre and collaborates closely with other specialty institutes to provide comprehensive patient care.
The clinic provides access to the latest treatments through advanced clinical trials. Patients benefit from a full range of diagnostic tools and imaging techniques, including upper endoscopy with endoscopic ultrasound, chromoendoscopy, and swallowing exams. Treatment plans are tailored to each patient, considering factors such as the type and stage of cancer, patient age, fitness, and personal preferences.
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Minimally invasive esophagectomy
The Cleveland Clinic offers a range of treatments for oesophageal cancer, including both traditional and minimally invasive esophagectomy. The Cleveland Clinic has earned a distinguished three-star rating from The Society of Thoracic Surgeons (STS) for its patient care and outcomes for esophagectomy.
During the procedure, patients are placed under general anaesthesia. After surgery, patients typically stay in the hospital for 7 to 14 days, with 1 to 3 days spent in the intensive care unit (ICU). Patients are advised to begin moving around as soon as possible after surgery and may not be able to eat for several days, initially starting with liquids. A feeding tube is inserted into the intestine during surgery to provide nutrition. Additionally, patients may have a tube coming out of the side of their chest to drain fluids and will wear special stockings to prevent blood clots. Pain medication is also administered through an IV or orally.
The University Hospitals Cleveland Medical Center is among a select number of teams in the nation performing minimally invasive esophagectomy and was the first site in Northeast Ohio to offer this procedure. Their division has one of the lowest combined in-hospital and 30-day mortality rates for elective esophagectomy in the country.
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Cleveland Clinic's thoracic surgery rating
Cleveland Clinic's Department of Thoracic Surgery is recognised for its expertise and care in the US and worldwide. The department offers virtually every type of surgical treatment for diseases of the lung and esophagus, including lung cancer, chronic obstructive pulmonary disease (COPD), lung failure, esophageal cancer, Barrett's esophagus, achalasia, and hyperhidrosis.
Cleveland Clinic surgeons have performed over 1,000 operations for esophageal cancer (esophagectomies) since 2000, with a safety profile much better than that reported nationwide by the Society of Thoracic Surgery (STS) (less than 2%). The clinic has earned a distinguished three-star rating from the STS for its patient care and outcomes for esophagectomy, placing it among the elite for general thoracic surgery in the US and Canada.
The Society of Thoracic Surgery's (STS) General Thoracic Surgery Database (GTSD) releases star ratings for outcomes for resection for lung cancer and esophagectomy for esophageal cancer. Cleveland Clinic achieved a three-star rating for both of these procedures in the latest database analysis, covering the three-year period from July 2021 to June 2024.
The clinic's Heart, Vascular & Thoracic Institute physicians, surgeons, and researchers are committed to improving patient care and outcomes by researching new treatments and therapies. They provide access to hundreds of clinical trials across all specialty areas, including heart surgery, where they have fine-tuned their program to meet the unique needs of patients and their families.
The University Hospitals Cleveland Medical Center also performs esophageal surgery and is ranked in the top 10% of all major academic hospitals in the US for reduced mortality and morbidity. Their length of stay is consistently less than the average at large academic medical centers.
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Esophageal reconstruction recovery
Esophageal reconstruction surgery is performed to treat issues within the esophagus, which can be caused by benign or malignant tumours, corrosive injury, radiation damage, or congenital disease. The surgery involves replacing the esophagus with a section of the small intestine, in a procedure known as an intestinal auto-transplant. This operation is performed to ensure a healthy blood supply to the transplanted intestine, and the small intestine is preferred over other tissues due to its similar size to the esophagus.
The recovery process for esophageal reconstruction surgery typically involves a hospital stay of around 7 to 10 days, with a median length of stay of 7 days at the UH Cleveland Medical Center. The specific recovery timeline and experience may vary depending on the patient's overall health, age, fitness level, and any other medical conditions present.
During the initial recovery period in the hospital, patients can expect to receive care from a multidisciplinary team, including oncologists, gastroenterologists, surgeons, nurses, dietitians, and pain management specialists. This team works together to provide a customized plan for each patient, ensuring the best possible care and fastest recovery.
After being discharged from the hospital, patients will need to follow a specific diet and nutrition plan as advised by their healthcare team. This may include the use of gastrostomy or jejunostomy tubes to ensure adequate nutrition and a gradual return to a normal diet. Patients should expect some pain and discomfort, and they will be provided with appropriate medications and pain management strategies.
The recovery process may also involve regular follow-up appointments with the healthcare team to monitor the patient's progress and identify any potential complications. It is important for patients to carefully plan and communicate with their healthcare providers during this time to ensure a successful recovery. Overall, esophageal reconstruction surgery has improved patient outcomes, with lower mortality and morbidity rates compared to conventional esophagectomy procedures.
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Esophageal cancer treatment options
The treatment options for oesophageal cancer depend on several factors, including the type and stage of cancer, and the patient's age, fitness, and medical history. Treatment options include surgery, radiation therapy, chemotherapy, targeted therapy, immunotherapy, and endoscopic procedures.
Surgery
Surgery is the most common treatment for early-stage oesophageal cancer that has not spread to the lymph nodes or other parts of the body. There are four common surgical procedures for treating oesophageal cancer, all of which involve removing all or part of the oesophagus, a portion of the stomach, and nearby lymph nodes. The remaining stomach is then pulled up into the chest or neck and connected to the remaining oesophagus.
Minimally invasive surgeries are also an option for treating oesophageal cancer. Surgeons at the UH Cleveland Medical Center are one of a select few teams in the nation performing these procedures.
Radiation Therapy
Radiation therapy uses focused, high-energy photon beams to destroy cancer cells. New radiation therapy techniques allow doctors to target tumours more precisely, delivering the maximum amount of radiation with minimal damage to healthy cells.
Chemotherapy
Chemotherapy works by killing fast-growing cells, including cancer cells. It can be used to treat oesophageal cancer before or after surgery and is useful for treating cancer that has metastasized.
Targeted Therapy
While many treatments directly kill cancer cells, targeted therapy works by stopping or slowing the growth or spread of cancer. Cancer cells need specific molecules (often proteins) to survive, multiply, and spread. These molecules are usually made by the genes that cause cancer, as well as the cells themselves. Targeted therapies are designed to interfere with, or target, these molecules or the cancer-causing genes that create them.
Immunotherapy
Immunotherapy recruits the patient's immune system to fight cancer. For oesophageal cancer, patients may be given immune checkpoint inhibitors, which cause the immune system to attack the tumour. Immunotherapy is most commonly used to treat advanced stages of oesophageal cancer.
Endoscopic Procedures
Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are complex but minimally invasive procedures that can treat early-stage oesophageal cancer. Doctors use an endoscope to remove the cancer without the need for incisions or the removal of the oesophagus.
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Frequently asked questions
Yes, Cleveland Clinic offers esophageal reconstruction surgery, also known as esophagectomy, to treat esophageal cancer. This procedure involves removing the damaged tissue and reconstructing the digestive system.
The Cleveland Clinic has achieved a distinguished three-star rating from The Society of Thoracic Surgeons (STS) for its patient care and outcomes for esophagectomy. This places the hospital among the elite for general thoracic surgery in the US and Canada.
Esophagectomy is an extensive surgery with associated risks of morbidity and mortality. However, Cleveland Clinic surgeons have performed over 1,000 esophagectomy procedures since 2000 with a safety profile better than the national average. The hospital's perioperative mortality rate is 0.7%, significantly lower than the 3.5% academic hospital benchmark.
