Esophagectomy is a technically complex operation performed for both benign and malignant esophageal disease. Medical and surgical advancements have led to improved outcomes in esophagectomy patients over the past several decades; however, surgeons must remain vigilant as complications happen often and can be severe. Post-esophagectomy complications can be grouped into early and late categories. The aim of this review is to discuss the early complications of esophagectomy along with their risk factors, work-up, and management strategies with special attention given to anastomotic leaks.

Sentinel lymph node (SLN) biopsy has revolutionized the staging and prognosis of breast cancer and melanoma. Because of the complicated lymphatic network around the esophagus, the utility of SLN biopsy for esophageal cancer is less clear. The accuracy of SLN mapping in esophageal cancer depends on tumor site, disease stage, use of neoadjuvant therapy, and patient characteristics. SLN biopsy may improve staging and result in less morbidity in patients with early esophageal cancer, compared with radical lymphadenectomy and esophagectomy. A recent study that investigated hybrid tracers in sentinel node navigation surgery (SNNS) demonstrated promising results for the detection of peritumoral SLNs. However, evidence that firmly establishes the concept of the SLN for esophageal cancer is still lacking. Big data analytics and artificial intelligence have been associated with improvements in the detection and prognosis of esophageal cancer. This review considers the roles of the evolving technologies of SLN biopsy and artificial intelligence, which together have the potential to further improve prognoses and outcomes for patients with esophageal cancer. Additional investigation is necessary to establish standardized protocols and to determine the long-term effectiveness of these approaches in settings involving neoadjuvant therapy and advanced-stage disease.

(1) Background: Barrett’s esophagus is a major risk factor for esophageal adenocarcinoma. In this pilot study, we employed precision mass spectrometry to map global (phospho)protein perturbations in Barrett’s esophagus lesions and adjacent normal tissue to glean insights into disease progression. (2) Methods: Biopsies were collected from two small but independent cohorts. Comparative analyses were performed between Barrett’s esophagus samples and adjacent matched (normal) tissues from patients with known pathology, while specimens from healthy patients served as additional controls. (3) Results: We identified and quantified 6810 proteins and 6395 phosphosites in the discovery cohort, revealing hundreds of statistically significant differences in protein abundances and phosphorylation states. We identified a robust proteomic signature that accurately classified the disease status of samples from the independent patient cohorts. Pathway-level analysis of the phosphoproteomic profiles revealed the dysregulation of specific cellular processes, including DNA repair, in Barrett’s esophagus relative to paired controls. Comparative analysis with previously published transcriptomic profiles provided independent evidence in support of these preliminary findings. (4) Conclusions: This pilot study establishes the feasibility of using unbiased quantitative phosphoproteomics to identify molecular perturbations associated with disease progression in Barrett’s esophagus to define potentially clinically actionable targets warranting further assessment.