Dr. Emmanuel
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  • Stomach and Oesophagus Centre
  • Competences
    • Oesophageal cancer
    • Stomach cancer
    • Liver cancer
    • Pancreatic Cancer
    • Colorectal cancer (colon)
    • Colorectal cancer (rectum/rectum)
    • Metastatic surgery
    • Peritoneal carcinomatosis (HIPEC/PIPAC)
    • Adrenal Tumors
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  • About
  • Stomach and Oesophagus Centre
  • Competences
    • Oesophageal cancer
    • Stomach cancer
    • Liver cancer
    • Pancreatic Cancer
    • Colorectal cancer (colon)
    • Colorectal cancer (rectum/rectum)
    • Metastatic surgery
    • Peritoneal carcinomatosis (HIPEC/PIPAC)
    • Adrenal Tumors
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A woman grabs her esophagus -

Oesophageal cancer

Your esophageal cancer specialist.

Because I have set myself the goal of ensuring the best possible life and quality of life for our patients suffering from esophageal cancer, I devote a large part of my energy to this topic. All members of our highly trained and experienced interdisciplinary team do a great job. I myself am considered an internationally recognized specialist in esophageal cancer.

Our individual treatment concept for esophageal cancer.

The oesophagus is a 30 - 40 cm long organ that runs through the throat, chest and abdominal cavity region and has a close positional relationship to the large blood vessels aorta, lung and heart. Since the oesophagus and trachea are directly next to each other, the trachea is closed off by the epiglottis for safety when swallowing.

Due to the complex anatomy is the treatment of esophageal diseases only Esophageal specialists and specialty centers The treatment concept should be tailored to the patient's individual needs - life situation, tumor biology and personal wishes. The treatment concept should be individually tailored to the patient's life situation, tumor biology and personal wishes.

Types of oesophageal cancer

In the oesophagus, oesophageal specialists distinguish between three different types of malignant cancer (oesophageal carcinoma).

Squamous cell carcinoma

Squamous cell carcinoma may affect all sections of the oesophagus. It is usually caused by smoking, often in combination with alcohol, but can also be virus-associated and thus also occur in younger people.

Adenocarcinoma

The so-called adenocarcinoma (AEG) of the oesophagogastric junction often develops due to tissue changes of the junction between the oesophagus and the stomach triggered by heartburn.

Oesophageal specialists distinguish between:

  • AEG I (in the oesophagus)
  • AEG II (between oesophagus and stomach)
  • and AEG III (at the uppermost part of the stomach).

This tumour is also called a "prosperity tumour" because there may be a connection with a long-standing reflux disease (heartburn).

Stromal tumors

Gastrointestinal stromal tumours of the oesophagus (GIST) are extremely rare, occur more frequently in the stomach and can be treated quite successfully. Depending on the size, location and activity of the tumour, oesophageal specialists may consider different treatment concepts.

Illustration of a tumor in the esophagus
Illustration of a tumor in the esophagus

Symptoms of oesophageal cancer

The typical symptoms of esophageal cancer are difficulty swallowing (Dyphagia) and the so-called globe feeling ("Lump in the throat"). In addition, it can also lead to the occurrence of cough, hoarseness, disgust for meat, night sweats and Loss of appetite come.
In general, it is advisable to have any symptoms clarified promptly by esophageal specialists in order to prevent them from spreading.

3D illustration of the human digestive system
3D illustration of the human digestive system

Diagnostics

Oesophageal specialists diagnose oesophageal cancer by means of an endoscopic reflection (gastroscopy), combined with endosonography, a special ultrasound of the oesophageal wall performed from the inside during the reflection. During this examination, a sample (biopsy) can be taken with the help of micro forceps, which is then examined for benignity or malignancy.

PET computed tomography in a hospital
PET computed tomography in a hospital

To complete the examination, oesophageal specialists arrange for a computer tomography of the abdominal and thoracic cavity and, if necessary, a PET (positron emission tomography). This high-tech method, together with the other diagnostic procedures, provides valuable information in the search for malignant tumours and their metastases. Special tumour markers in the blood are used to monitor the progress and success of the therapy.

Doctor explains the form of treatment

Oesophageal cancer treatment

If oesophageal cancer is diagnosed, the extent of the tumour determines the respective therapy. If there are no metastases in other organs, surgery is the best solution.

Removal of an early carcinoma in the esophagus
Removal of an early carcinoma in the esophagus

Early carcinomas

In very early stages, when the tumour is only limited to the mucosa of the oesophagus, it can be removed by endoscopic procedures through the mouth, without incisions. This tumour size is usually only discovered by chance, as there are usually no symptoms such as swallowing difficulties or globus sensation yet.

Advanced carcinomas

If the tumour (whether squamous cell carcinoma or adenocarcinoma of the oesophagogastric junction) has crossed the mucosal border, oesophageal specialists choose from the following procedures:

Surgery: conventional, minimally invasive, robot-assisted

The surgical procedure is based on a concept that is tailored to you and the tumour disease. Gentle, state-of-the-art, minimally invasive and robot-assisted removal of the oesophagus is used.

New oesophagus / interpositions

If the oesophagus has to be partially or completely removed, it can be reconstructed and replaced by various other organs such as the stomach, the small intestine or the colon. This depends on the patient's individual situation and is tailored to you.

Multimodal, interdisciplinary concepts

Above a certain tumour size, experts achieve the best healing success with a multimodal, interdisciplinary concept. In this case, before and after the operation, additional medical tumour therapy and/or radiotherapy is carried out.

Medical tumour therapy / radiotherapy

If surgery cannot be performed on patients due to their general condition and the presence of metastases, drug-based tumour therapy and/or radiotherapy are available - supplemented by endoscopictherapy.

Endoscopy

Endoscopic therapy can be a complementary measure to preserve the swallowing function and to ensure a high quality of life.

Cohesion of the interdisciplinary team of surgeon Dr. EMMANUEL

Your interdisciplinary treatment team

This type of treatment requires close interaction between a wide range of disciplines, such as oncology, radiology, endoscopy, radiotherapy and surgery. Therefore, it is only possible at centres. We have the necessary practical experience to perform this difficult procedure.

Life after the operation

Generally, no special rehabilitation is necessary after the hospital stay.

We recommend that you have a nutritional consultation with us at the hospital. In principle, the consumption of all foods and drinks in somewhat smaller portions is possible again. Thanks to the latest surgical techniques, a very good quality of life can be achieved even after complete removal of the oesophagus.

After the operation, you will receive an individual aftercare pass from us, in which a regular check of the healing success (tumour aftercare) is carried out.

 

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Dr. Emmanuel

Contact

Univ.-Prof. Dr. Klaus EMMANUEL, F.A.C.S.

Head of the Department of General, Visceral and Thoracic Surgery at Salzburg University Hospital, Paracelsus Medical University

Johann-Wolf-Strasse 15
5020 Salzburg

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