CT Scanning in Oesophageal Surgery

The value of a CT scan in the assessment of oesophageal surgery is in the determination of inoperability i.e. the presence of metastatic disease, and/or local invasion. 

Specific points to look for include:

1. Site of tumour, and its size
2. Local structures ? invaded by tumour

   Lower third tumours abut the aorta - the only definitive way to determine if the aorta is invaded is open surgical  assessment. Don't rely on radiological fat planes, there isn't one between the oesopahgus and the aorta.

   Mid third tumours - Membranous tracheal involvement needs to be assessed here, bronchoscopy can help and should always be utilised in mid third tumours.

    

3. Liver metastasis - An ultrasound scan may be needed here.
4. Pulmonary metastasis
5. Coeliac lymphadenopathy in Lower 1/3 tumours

Mid third tumour

Lower third tumour

Coeliac Lymphadenopathy

Mid third tumour

Lower third tumour

Also has Bronchiestasis

Coeliac Lymphadenopathy