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The Esophageal Program at the Massachusetts General Hospital Division of Thoracic Surgery employs a variety of minimally invasive and traditional surgical approaches to treat esophageal diseases. 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.
Each patient's situation is unique and requires careful consideration of many factors to determine the best treatment options for his or her esophageal disease.
Our multidisciplinary approach to surgical care also benefits the patient. We work collaboratively with surgeons in Massachusetts General Hospital’s Gastroesophageal Surgery Program, who specialize in complex surgical techniques to treat patients with esophageal cancers. We also work closely with our colleagues in medical oncology and radiation therapy in treating esophageal tumors. If a patient has other diseases in addition to the esophageal disorder, we involve 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 Multidisciplinary Thoracic Oncology Clinic. In this case, we work with the patient to determine the most appropriate treatment plan. Typically, multimodality therapy (i.e., surgery in combination with radiation therapy and/or chemotherapy) produces the greatest benefit for patients with locally advanced esophageal cancer.
Our high volume of surgery — 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. In our care, we emphasize surgical and anesthetic techniques that enable early mobilization and a shorter stay.
Our division offers diagnostic and therapeutic services for benign esophageal diseases including:
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 procedures we perform include:
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 resection, while patients with locally advanced cancers may first receive chemotherapy, with or without radiation. 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:
For patients whose clinical conditions make them unsuitable to receive surgical treatement and thus require palliative treatment, we may offer photodynamic therapy (using lasers to remove blockages of the esophagus) or stents (if blockages exist and cannot be managed with laser techniques) to improve swallowing.
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.
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 (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) 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
Division of Thoracic Surgery
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