title: Postoperative imaging of esophageal cancer: what chest radiologists need to know.
abstract: A variety of surgical procedures are used in the treatment of esophageal cancer. These procedures include transthoracic esophagectomy (Ivor Lewis procedure, McKeown procedure, left thoracoabdominal approach), transhiatal esophagectomy, and various forms of bypass surgery. Although meticulous surgical techniques and improved postoperative care have markedly reduced the complications associated with these techniques, esophageal resection is still associated with various intraoperative complications (hemorrhage, injury to the tracheobronchial tree, recurrent laryngeal nerve injury) and postoperative complications (anastomotic leak; mediastinitis; respiratory problems, including pleural effusion, pneumonia, and acute respiratory distress syndrome; cardiac and functional complications). Postoperative tumor recurrence is not uncommon in patients undergoing curative resection for esophageal cancer and can be categorized as either locoregional (locoregional lymph node metastases, anastomotic recurrence) or distant (hematogenous metastases, pleural or peritoneal seeding). Hematogenous metastases most commonly involve the liver, lungs, and bones, followed by the adrenal glands, brain, and kidneys. Hematogenous metastases may also involve multiple organs simultaneously. The sophisticated surgical procedures used in esophagectomy can result in anatomic changes and confound image interpretation. The radiologist must understand how these procedures can affect imaging data and be familiar with the appearances of postoperative anatomic changes, complications, and tumor recurrence to ensure accurate evaluation of affected patients.
authors: Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do, South Korea.
authors: Tae Jung
authors: TJ
authors: Kim
authors: Kyoung Ho
authors: KH
authors: Lee
authors: Young Hoon
authors: YH
authors: Kim
authors: Sook Whan
authors: SW
authors: Sung
authors: Sanghoon
authors: S
authors: Jheon
authors: Suk-ki
authors: SK
authors: Cho
authors: Kyung Won
authors: KW
authors: Lee
mesh_terms: D004938:Esophageal Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects* / Q000379:methods; D006470:Hemorrhage / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000517:prevention & control*; D013902:Radiography, Thoracic / Q000379:methods*