Esophagectomy

(Removal of the Esophagus)

Definition

An esophagectomy is the removal of part or all of the esophagus. The esophagus is the tube that runs from the mouth to the stomach.

Reasons for Procedure    TOP

Esophagectomy may be used to treat:

Esophageal Cancer

Esophageal cancer
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Possible Complications    TOP

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review possible problems such as:

  • Bleeding
  • Blood clots
  • Infection
  • Sore throat
  • Reaction to the anesthesia
  • Leaks from the internal stitches which may cause scarring
  • Heart attack

Your problems are higher for:

What to Expect    TOP

Prior to Procedure

You may have:

Leading up to your procedure:

  • Talk to your doctor about your medicines. You may be asked to stop taking some up to 1 week in advance.
  • Arrange for a ride home.
  • Arrange for help at home.
  • Eat a light meal the night before. Do not eat or drink anything after midnight.
  • Your doctor may ask you to:
    • Use an enema to clear your intestines
    • Follow a special diet.
    • Take antibiotics or other medications.
    • Shower using antibacterial soap the night before the surgery.

Anesthesia

General anesthesia will be used. You will be asleep.

Description of the Procedure    TOP

The doctor will make a cut in the neck, chest, or belly. The techniques used are:

  • An open procedure using 1 large cut. The diseased area is found and removed.
  • A laparoscopic procedure that uses several small cuts. A tiny camera and small tools are inserted in tubes placed in the cuts. The esophagus can be seen on a screen. The diseased area will be found and removed.
  • A robot-assisted procedure

A replacement esophagus is formed with part of the stomach or large intestine. The remainder of the esophagus will be attached to this replacement. In some cases when treating cancer, lymph nodes in the area will be removed. One or more chest tubes are placed to drain fluids. Lastly, the cuts are closed with stitches or staples.

How Long Will It Take?    TOP

About 6 hours

How Much Will It Hurt?    TOP

Anesthesia will prevent pain during surgery. Medicines will help ease pain afterwards.

Average Hospital Stay    TOP

This is done in a hospital. The usual length of stay is 1-2 weeks. Your doctor may choose to keep you longer if you have problems.

Post-procedure Care    TOP

At the Hospital

You will not be able to eat or drink during the first week after surgery. You will get nutrition through a feeding tube. Within 7-14 days, you will have a swallowing test to check for leaks. If cleared, your diet is resumed. It will progress from clear liquids to soft, solid meals. This can take up to a month. Your stomach may be smaller, so you will need to eat smaller portions.

You will also need to do deep breathing exercises. You may be given an incentive spirometer. This is a device to help you breathe deeply.

During your stay, the healthcare staff will take steps to lower your chances of infection such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

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At Home

To help you heal faster at home:

  • Avoid heavy lifting for 6-8 weeks.
  • Do home exercises as advised.
  • Follow instructions to keep your wound from getting infected.

Call Your Doctor    TOP

Call your doctor if any of the following occur:

  • Fever or chills
  • Redness, swelling, pain, excess bleeding, or pus from the wound
  • Nausea or vomiting
  • Pain that you can't control with the medicines you were given
  • Coughing, breathing problems, or chest pain
  • Constipation
  • Diarrhea
  • Pain or swelling in your feet, calves, or legs
  • Swallowing problems

If you think you have an emergency, call for emergency medical services right away.

RESOURCES:

American Cancer Society
https://www.cancer.org
National Cancer Institute
https://www.cancer.gov

CANADIAN RESOURCES:

Canadian Cancer Society
https://www.cancer.ca

References:

Esophageal disorders. Boston Medical Center website. Available at: https://www.bmc.org/gastroenterology/esophageal-disorders. Accessed July 2, 2018.
Esophagectomy. Massachusetts General Hospital website. Available at: https://www.massgeneral.org/digestive/services/procedure.aspx?id=2296. Accessed July 2, 2018.
Esophagectomy. Memorial Hermann website. Available at:
...(Click grey area to select URL)
Accessed July 2, 2018.
Esophagectomy. UCSF website. Available at: https://surgery.ucsf.edu/conditions--procedures/esophagectomy.aspx. Accessed July 2, 2018.
Management of esophageal and esophagogastric junction cancer. EBSCO DynaMed Plus website. Available at: http://www.dynamed... . Updated June 20, 2018. Accessed July 2, 2018.
Surgical removal of the esophagus (esophagectomy). UC Davis Health System website. Available at:
...(Click grey area to select URL)
Accessed July 2, 2018.
Last reviewed May 2018 by EBSCO Medical Review Board Donald W. Buck II, MD
Last Updated: 7/2/2018

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