Esophageal cancer other diagnostic studies

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]

## Overview

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Laparoscopy, thoracoscopy and bronchoscopy can be used in addition to EUS and CT in locally advanced esophageal cancer to accurately diagnose and stage lymph node metastasis.

## Other Diagnostic Studies

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### Laparoscopy and Thoracoscopy

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* Laparoscopic and thoracoscopic staging can be used to more accurately stage regional lymph nodes (particularly celiac and intrathoracic) as compared to EUS.[1][2]
* They can be used to determine intraperitoneal metstases in those patients with distal esophageal adenocarcinomas.[3]
* Furthermore, laparoscopy and thoracoscopy is used to limit aggressive treatment in those who have a locally advanced cancer.

### Bronchoscopy

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* Preoperative bronchoscopy with biopsy and brush cytology has been implemented recently as the last phase in staging workup in those with a locally advanced tumor that is located at or above the carina.[4]

## References

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1. ↑ Kaushik N, Khalid A, Brody D, Luketich J, McGrath K (2007). "Endoscopic ultrasound compared with laparoscopy for staging esophageal cancer". Ann. Thorac. Surg. 83 (6): 2000–2. doi:10.1016/j.athoracsur.2007.02.023. PMID 17532386.
2. ↑ Krasna MJ, Reed CE, Nedzwiecki D, Hollis DR, Luketich JD, DeCamp MM, Mayer RJ, Sugarbaker DJ (2001). "CALGB 9380: a prospective trial of the feasibility of thoracoscopy/laparoscopy in staging esophageal cancer". Ann. Thorac. Surg. 71 (4): 1073–9. PMID 11308139.
3. ↑ Bryan RT, Cruickshank NR, Needham SJ, Moffitt DD, Young JA, Hallissey MT, Fielding JW (2001). "Laparoscopic peritoneal lavage in staging gastric and oesophageal cancer". Eur J Surg Oncol. 27 (3): 291–7. doi:10.1053/ejso.2001.1113. PMID 11373108.
4. ↑ Riedel M, Hauck RW, Stein HJ, Mounyam L, Schulz C, Schömig A, Siewert JR (1998). "Preoperative bronchoscopic assessment of airway invasion by esophageal cancer: a prospective study". Chest. 113 (3): 687–95. PMID 9515844.

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