Preoperative Preparation for Esophageal Surgery

Esophageal surgeries can be placed into two broad categories: anatomic modifications for benign esophageal disorders and resections for carcinomas. The clinical setting and scope of intervention are different for these two groups, as is the preoperative preparation. The goal of preoperative evaluation for benign esophageal disease is to make an accurate and complete diagnosis; the tools for this include barium esophagogram, endoscopy, pH monitoring, and manometry. The preoperative concerns for esophageal resection for cancer involve accurate staging of the cancer, using CT, positron emission tomography, and endoscopic ultrasound, and complete physiologic evaluation of the patient to determine his or her ability to withstand a large operation.