|
"The vast majority of our transhiatal esophagectomy patients return home quickly and enjoy near-normal lifestyles and eating habits."
—Mark Iannettoni, MD
As David Weiner worked in the air-conditioned comfort of his office, he was suddenly overwhelmed by a debilitating sensation, like a rapid loss in blood pressure.
"Blood was rushing from my head and I broke out into a complete sweat," he says.
Weiner couldn’t move.
"I pride myself on being in good shape," says the 70-year-old commercial real estate broker from Rock Island, Ill. "So I knew something was going on."
Ten minutes passed before a feeling of normalcy returned. After talking to co-workers and calling his physician, he headed for the emergency room at Rock Island’s Trinity Medical Center West.
Doctors soon discovered that Weiner was anemic.
"They told me it was because I was bleeding internally," he says. "I stayed overnight for an endoscopy so they could figure out why."
Following the endoscopy, Trinity oncologist David Spector, MD, told Weiner that he had a tumor embedded in the wall of his lower esophagus. A biopsy confirmed the tumor was cancerous.
Stunned, Weiner hunted more information. A Web search revealed that the operation of choice for removing the esophagus—a transhiatal esophagectomy—was pioneered at the University of Michigan by a surgeon named Mark Orringer.
"I assumed I would be trekking to Michigan for the surgery," Weiner says.
During a follow-up visit with Spector, however, Weiner changed his plans. It turned out the procedure was also performed by Mark Iannettoni, MD, a surgeon with the Holden Comprehensive Cancer Center at The University of Iowa.
In fact, before being recruited to UI Hospitals and Clinics, Iannettoni had partnered with Orringer in developing esophageal resections at Michigan.
After visiting Iannettoni, Weiner was convinced. As a precursor to surgery, he underwent a seven-week regimen of radiation and chemotherapy at Trinity.
The actual procedure was performed Oct. 3, 2005 and went off without a hitch. No admission to the intensive care unit was required, and he didn’t need a ventilator.
In fact, Weiner returned home after seven days, returned to work after three weeks, and resumed physical workouts after 90 days.
"I am 98.5 percent back to normal," he says. "The few side-effects are mild and I am pretty much doing what I want. And I’m cancer-free!"
Weiner praised the team of caregivers responsible for his treatment, including Iannettoni, thoracic nurse coordinator Kelley McLaughlin, RN, the thoracic recovery nursing staff, and other health care professionals who called on him 24/7 during his week in the hospital.
"The care I received was absolutely the best, very professional," he says.
For more information about esophageal cancer, patients and family members may:
For consultation or referral, physicians should call UI Consult.
—Michael Sondergard
Advantages
The benefits of transhiatal esophagectomy include:
- Lower risk of local cancer recurrence
- No chest opening
- Six- to seven-day hospital stay
- Resumption of regular diet prior to discharge
How its done
In transhiatal esophagectomy, surgeons use an upper abdominal incision to free the esophagus by working upward through the diaphragm. The esophagus is removed through a three-inch incision in the neck. The stomach is then moved into the chest until its upper end appears in the neck wound. The remaining esophagus is connected to the stomach in the neck, allowing the stomach to act as a replacement for the esophagus. |
