Esophageal Program

The Esophageal Program in Massachusetts General Hospital's Division of Thoracic Surgery provides surgical treatment for esophageal cancer and a variety of benign esophageal disorders.
Request an Appointment

Call to request an appointment or refer a patient: 617-726-6826

Overview

The Esophageal Program at the Massachusetts General Hospital Division of Thoracic Surgery employs a variety of minimally invasive and traditional surgical approaches to comprehensively treat esophageal diseases. Conditions include esophageal cancer, esophageal reflux, paraesophageal hernia and benign esophageal tumor. The Division of Thoracic Surgery has board-certified thoracic surgeons with decades of institutional and individual experience. We create an individualized treatment approach for each patient and often work together with physicians from other medical specialties to treat the most challenging patients and conditions.

Superb Surgical Results

Our high volume of surgical cases and skilled team of surgeons, anesthesiologists, nurses, physical therapists and speech therapists help us to attain excellent results in treating patients with esophageal cancer and other complex conditions of the esophagus. We utilize surgical and anesthetic techniques that enable patients to return to normal movement quickly and experience a shorter hospital stay.

About this Program

Cancer of the Esophagus & Esophagogastric Junction

Esophageal cancer presents in two main forms: squamous cell carcinoma and esophageal adenocarcinoma.

All patients will meet with a surgeon before treatment. Patients with early esophageal cancer first undergo surgical removal of the cancer, while patients with locally advanced cancers generally receive chemotherapy and radiation before surgery. We choose the most appropriate surgical approach for esophageal cancer based on the disease and the patient’s needs. Generally, these procedures involve removing all or part of the esophagus and some of the surrounding tissue:

Benign Conditions and Procedures of the Esophagus

Our division offers diagnostic and therapeutic management of benign esophageal diseases. The majority of our patients with benign esophageal conditions can be treated with minimally invasive laparoscopic or thoracoscopic procedures. These allow our patients to enjoy a significantly quicker recovery.

The conditions we treat and procedures we perform include:

  • Gastroesophageal reflux disease (GERD): digestive disorder that is caused by gastric acid flowing from the stomach into the esophagus

    GERD is treated by laparoscopic fundoplication which is a technique in which the stomach is wrapped around the outer (distal) esophagus to treat severe acid reflux. Anti-reflux surgery can also be performed. Our division is a referral center for patients that have problems after prior reflux surgery which is called re-operative gastroesophageal reflux surgery.

  • Achalasia: failure of muscle fibers to relax, which prevents the esophagus from squeezing food into the stomach.

    Achalasia is treated by laparoscopic Heller myotomy, which is a technique in which an incision is made in the muscle of the esophagus to relieve the difficulty with swallowing food.

  • Esophageal diverticulum: pouch that branches out from the esophageal lining between the throat and the stomach, such as Zenker's diverticulum.

    Esophageal diverticulum is treated by removing the pouch from the esophageal lining.

  • Paraesophageal hernia: treated by either a laparoscopic or trans-thoracic approach which is used to restore the normal abdominal position of a stomach that has herniated into the chest.

  • Benign (non-cancerous) tumors such as leiomyoma

  • Esophageal cysts

  • Barrett's esophagus: a condition affecting the lining of the esophagus, the swallowing tube that carries food and liquids from the mouth to the stomach. Barrett’s esophagus is a change in the lining of the esophagus from a normal, white lining to a pink/red lining.

  • Cricopharyngeal myotomy: dividing the muscles of the cricopharyngeal muscle (muscle encircling the upper end of the esophagus) to relax it and allow food to pass.

  • Colon and jejunal interposition for complex esophageal reconstruction: Our division is a leading referral center for complex reconstruction following complicated prior reconstruction after esophagetomy.

What to Expect

Each patient's situation is unique and requires careful consideration of many factors to determine the best treatment options and care team for his or her esophageal disease. We work collaboratively with surgeons in Mass General’s Gastroesophageal Surgery Program, who specialize in complex surgical techniques to treat patients with esophageal cancers or other non-cancerous esophageal conditions. We also work closely with our colleagues in medical oncology and radiation therapy in treating esophageal cancer. If a patient has other diseases in addition to the esophageal disorder, we involve additional world-class Mass General specialists — cardiologists, pulmonologists, anesthesiologists, pain medicine specialists and others — to help the patient safely through the procedure and back to health.

As a first step, new patients meet with one of our thoracic surgeons to determine the most effective course of treatment and whether further evaluation is needed.

If additional evaluation by an oncologist and radiotherapist is needed, we may refer patients with esophageal cancer to the Mass General Cancer Center’s Center for Thoracic Cancers multidisciplinary clinic. Typically, multimodality therapy (i.e., surgery following radiation therapy and chemotherapy) produces the greatest benefit for patients with locally advanced esophageal cancer.

Patient Outcomes

At Mass General, we believe it's important to provide safe and effective care. The Department of Surgery tracks many performance measures and compares them to national data. On the following pages, you can view some of these metrics.

Esophagectomy for Cancer Case Volumes

Esophagectomy for Cancer Case Volumes
See how Mass General’s esophagectomy for cancer case volumes compare to the national average.

Esophagectomy for Cancer Outcomes

Esophagectomy for Cancer Outcomes
Learn about Mass General's esophagectomy outcomes compared to the Society of Thoracic Surgeons norms.

Patient Ratings of Thoracic Surgeons

Patient Ratings of Thoracic Surgeons
See how Mass General’s thoracic surgery patients rate their doctors.                                      

Conditions & Diseases

  • Barrett's Esophagus

    Barrett's esophagus is a condition in which normal cells that line the esophagus turn into cells not usually found in humans called “specialized columnar cells.”

  • Esophageal Cancer

    Esophageal cancer is cancer that develops in the esophagus, the muscular tube that connects the throat to the stomach.

  • Gastroesophageal Reflux Disease (GERD) / Heartburn

    Gastroesophageal reflux disease (GERD) is a digestive disorder that is caused by gastric acid flowing from the stomach into the esophagus.

News

  • Getting Back to Active: Bob's Story - 12/1/2014, Mass General

    Bob Hazelton lived with chronic acid reflux for years and was diagnosed with esophageal cancer in 2011. After his surgical team at Massachusetts General Hospital performed a minimally invasive esophagectomy, Bob has a healthy esophagus and is getting back to his active lifestyle.

Video

  • Endoscopic Mucosal Resection

    Endoscopic Mucosal Resection

    Endoscopic mucosal resection (EMR) is a specialized endoscopic technique used by gastroenterologists at the Massachusetts General Hospital Digestive Healthcare Center to diagnose and remove large areas of early gastrointestinal cancers.

  • Radiofrequency Ablation Treatment

    Radiofrequency Ablation Treatment

    Radiofrequency ablation (RFA) is an FDA-approved endoscopic technique used by specialists at the Massachusetts General Hospital Barrett's Esophagus Treatment Center to treat Barrett's esophagus.

  • Minimally Invasive Esophagectomy (MIE)

    Minimally Invasive Esophagectomy (MIE)

    Minimally invasive esophagectomy (MIE) is a procedure performed by Massachusetts General Hospital surgeons using small incisions to remove a diseased esophagus and reconstruct the gastrointestinal tract. For more information, visit massgeneral.org/MIE

  • Anesthesia

    General Anesthesia Educational Video

    Learn more about general anesthesia in this educational video.

Contact

Contact Us

Division of Thoracic Surgery

Founders 755 Fruit Street Boston, MA 02114
  • Phone: 617-726-6826
Request an Appointment

Call to request an appointment or refer a patient: 617-726-6826

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