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Supplement: The Minimally Invasive Thoracic Surgery Summit

How to Keep the Treatment of Esophageal Disease in the Surgeon’s Hands

The Heart, Lung, and Esophageal Surgery Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania

^_* Address correspondence to Dr Luketich, The Heart, Lung and Esophageal Surgery Institute, University of Pittsburgh Medical Center, 200 Lothrop St, Ste C-800, Pittsburgh, PA 15213–3221 (Email: luketichjd@upmc.edu).

Presented at the Minimally Invasive Thoracic Surgery Summit, New York, NY, June 8–9, 2007.

The first 300 words of the full text of this article appear below.

	Introduction

 
Disorders of the esophagus span a wide spectrum of diseases from gastroesophageal reflux disease (GERD) to motility disorders such as achalasia to esophageal cancer. The management of these disorders varies considerably from medical treatment in uncomplicated GERD to esophagectomy in esophageal cancer. In addition, several endoscopic therapies are emerging in the management of not only benign disorders but also malignant diseases of the esophagus [1, 2]. It is critical that the esophageal surgeon practice disease-based therapy. Specifically, the surgeon should not only be familiar with, but actually perform diagnostic testing, medical management, and endoscopic therapeutic interventions in addition to surgery for the broad spectrum of esophageal disorders.

The current era is a critical time for esophageal surgeons for several reasons. For example, the incidence of esophageal carcinoma has increased dramatically over the past three decades (Fig 1), and the number of patients with GERD seeking alternatives to medical therapy is increasing. Thus, the pool of patients with esophageal disorders needing interventions is expanding [3].

View larger version (27K):   Fig 1. The incidence of squamous cell carcinoma (black males, filled squares; white males, open squares) and adenocarcinoma (black males, filled circles; white males, open circles). (Reprinted with permission from Devea SS, Blot WJ, Fraumeni JF. Changing patterns in the incidence of esophageal and gastric carcinoma in the United States. Cancer 1998,83:2049–53. Copyright 1998 American Cancer Society. This material is reproduced with the permission of Wiley-Liss, Inc, a subsidiary of John Wiley & Sons, Inc.)