The anaesthetic experience in three patients undergoing thoracoscopic oesophagectomy is discussed. The indications for surgery and the premorbid states are outlined. The necessity for one-lung ventilation, with its attendant cardiopulmonary effects, the difficulty of patient access and the assessment of blood loss were the main problems encountered. Pulmonary morbidity was high in the post-operative period despite the avoidance of thoracotomy. Two patients developed persistent vocal cord paralysis. In conclusion, the role of thoracoscopic oesophagectomy needs further evaluation.
Esophageal cancer is the eighth most common cancer worldwide, and the incidence of esophageal carcinoma is rapidly increasing. With the advent of new staging and treatment techniques, esophageal cancer can now be managed through various strategies. A good understanding of the advances and limitations of new staging techniques and how these can guide in individualizing treatment is important to improve outcomes for esophageal cancer patients. This paper outlines the recent progress in staging and treatment of esophageal cancer, with particularly attention to endoscopic techniques for early-stage esophageal cancer, multimodality treatment for locally advanced esophageal cancer, assessment of response to neoadjuvant treatment, and the role of cervical lymph node dissection. Furthermore, advances in robot-assisted surgical techniques and postoperative recovery protocols that may further improve outcomes after esophagectomy are discussed.