ABSTRACT
Preop 1. Accurate diagnosis of the esophageal disease is accomplished by a detailed history,
barium esophagogram, pH and manometric evaluation and endoscopy with biopsy. 2. In resections for esophageal cancer, rigorous tumor staging is necessary to deter
mine that the lesion is localized and therefore amenable to a curative resection. This is accomplished by clinical evaluation (history and physical examination) and by computed tomographic (CT) scan of the chest and abdomen. Endo scopic ultrasound (EUS) is routinely used to assess the depth of penetration of the esophageal wall by the tumor (T stage). Additionally, EUS is used to assess nodal stage by using echo characteristics and directed fine needle aspiration (N stage). PET scanning is also commonly used to identify distant metastases (M stage). Preoperative surgical staging using thoracoscopy and laparoscopy has also been described but has not been universally accepted.
