Surgery (Esophagus & Small Intestine)

Operative treatment of esophageal cancer carries up to a 40% mortality rate and 10% five-year survival. Surgery is most effective for esophageal cancers in the distal half. Maintaining nutrition is extremely important; however, esophageal feeding tubes, colonic interpositioning, and feeding gastrostomies are each accompanied by high morbidity.

Laser surgery can help to maintain an open passageway for nutrition.

For carcinoid tumors less than 1 cm in diameter, local resection is the treatment of choice. If the tumor is larger than 1 cm, the resection should include regional lymph nodes from the mesentery.

Key:
X = complete
* = partial
o = optional
• = see note under procedure

Tissues Removed
Types of Surgery Lesion Stomach
(Upper)		 Stomach
(Lower)		 Lymph
Nodes		 Other
Organs
Cryosurgery *
Cautery, fulguration (without specimen) *
Laser surgery with specimen */X
Excisional biopsy *
Polypectomy *
Excision of lesion *
Partial/simple surgical removal, primary site no lymph node dissection X
Partial/simple surgical removal, primary site with lymph node dissection X X
Debulking procedure (so stated) with or without lymph node dissection X */° °
Radical surgery, primary site X X °
Surgery of regional/distant sites/nodes only °