Doctors use new technique to make esophagus

Doctors at Stanford Hospital are now combining delicate surgical techniques to literally create a new esophagus.
January 21, 2014 7:52:43 PM PST
For patients suffering from cancer at the esophagus, returning to a normal life can be a daunting challenge. But doctors at Stanford Hospital are using new techniques to create a new esophagus.

You'd be hard pressed to find someone who appreciates home-made salsa quite the way Gilbert Hudson does. Especially when you consider that a few months ago he wasn't able to swallow at all.

"I was in pretty bad shape. I had a colposcopy bag on my neck and a feeding tube and pretty well depressed," Hudson said.

"What you're looking at is basically the area of his esophagus and that's being occupied by the tumor," Gordon Lee, M.D. said.

Doctors had discovered advanced cancer in Hudson's esophagus.

Although the tumor was removed, efforts to reconstruct his esophagus failed.

That's when he turned to doctors at Stanford Hospital.

"It's heartbreaking actually, particularly when they're unable to swallow or eat any kind of food. It's really socially debilitating to them. So, my first thought honestly was I really wanted to help him," Lee said.

Micro-surgeon Lee says the Stanford team decided on a rare, but increasingly successful approach using a section of Hudson's small intestine to rebuild his esophagus and link it to the remaining portion of his stomach.

"You've got 30 feet of bowel in your abdomen, so using the small intestine is a logical choice," Lee said.

Over the course of several hours, the Stanford team resected part of the small intestine taking special care to preserve its vascular structure and then carefully transplanted it ultimately building a replacement esophagus.

"No one person can do this by themselves. It really is complicated and it's a team effort. It obviously is the combined effort of both myself along with thoracic surgeon and surgical oncologist," Lee said.

Recovery is still a difficult process.

With the volume of the stomach reduced dramatically, Hudson says he was able to ingest only small amounts of food taken every couple of hours.

Still Lee says images show the ultimate measure of Hudson's recovery and his ability to swallow through the reconstructed esophagus.

"In fact Mr. Hudson's result is exactly what we expect all patients to have after surgery. We expect them to resume a normal regular diet," Lee said.

And although those spicy foods like salsa are not high on the list of recommended foods for Hudson, they're a pleasure he thought he might never experience again.

"Oh yes, when you can't eat for about five or six months, eating is something else," Hudson said.

Doctors used another surgical technique to monitor his recovery. After the procedure they extended a tiny flap of tissue through to the outside of his skin and that allowed them to monitor blood supply reaching the transplanted esophagus.


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