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Surgery

At Johns Hopkins, surgery is a standard part of the treatment for many esophageal cancers, often preceded by chemotherapy and radiation treatments. Surgery to treat esophageal cancer is a complex operation that requires experience and specialized knowledge in order to provide the patient with a positive prognosis and a good post-surgery quality of life. Our surgeons perform between 60 and 100 surgeries to treat esophageal cancer each year, among other complex esophageal surgeries not related to cancer. 

According to several large studies, surgery results are better when the surgery is done at a medical center that do a high volume of esophageal surgeries. In high-volume centers, like Johns Hopkins, the mortality rate is 4 percent, compared to a 17 percent mortality rate at low-volume centers, according to a 2009 study.

Johns Hopkins is one of the few medical centers in the country that offers minimally invasive surgery for esophageal cancer (also known as minimally invasive esophagectomy). Depending on a patient’s diagnosis, the surgeons at Johns Hopkins will recommend the type of surgery that offers the patient both the best possible outcome and the least invasive surgery possible to achieve that outcome.

Read more about surgery for esophageal cancer at Johns Hopkins:

Types of surgery

The foundation of our esophageal cancer surgery program is the experience and expertise of our surgeons and the fact that they are intensively involved in each patient’s case. With access to the latest technologies and techniques, many of which were pioneered at Johns Hopkins, the surgeons’ goal is to give patients the best possible outcome and quality of life after the surgery.

They work hand in hand with a number of other esophageal cancer experts, including gastroenterologists, pulmonologists, radiation oncologists, and medical oncologists. Every type of medical expertise is available at Hopkins, often only a short walk down a hallway to consult.

These are the types of surgery commonly performed to remove esophageal cancers (surgery for esophageal cancer is also often referred to as an esophagectomy):

Transhiatal surgery: In this type of surgery, the surgeon makes incisions in the neck and abdomen in order to remove the tumor. This approach avoids an incision in the chest, but cannot be used if the tumor involves a portion of the stomach or if there are lymph nodes in the chest that must be removed.

Ivor-Lewis surgery: In this type of surgery, which is most often used when the tumor is closer to the stomach or if there are lymph nodes in the chest that need to be removed, the surgeon makes incisions in the abdomen and the right side of the chest.

Minimally invasive surgery: Johns Hopkins is one of the few medical centers in the country that offers minimally invasive surgery for esophageal cancer (also known as minimally invasive esophagectomy or MIE). Minimally invasive surgery can offer significant benefits, such as shorter hospital stays, shorter recovery times, and less scarring. At Hopkins, it is used when it will benefit the patient in the long term by offering the best possible prognosis.

Robotic surgery: A robotic esophagectomy, is done using robotic arms to manipulate tiny surgical instruments that allow the surgeon complete range of motion and the same precision as other types of surgery. Its offers the same advantages as minimally invasive surgery.

Head and neck esophageal cancers

Certain types of tumors are treated by head and neck specialists. Cervical esophageal cancer is most often treated with chemotherapy and radiation alone. Pharyngeal cancers (those located in the middle part of the throat) are commonly treated with surgery, done by a head and neck surgeon working with a thoracic surgeon specializing in esophageal cancer.

Ablative therapies

In some cases, these ablative therapies may be recommended to treat pre-cancerous esophageal conditions, such as Barrett’s esophagus or dysplasia, or early-stage esophageal cancer.

For an appointment and answers to your questions

As a leading treatment center for esophageal cancer, Johns Hopkins sees between 50 and 100 newly diagnosed patients a year, providing a depth of experience that assures our patients that they will receive the best possible treatment plan for their diagnosis.

To make an appointment or if you have questions, call 410-933-5420.

 

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