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Esophagectomy
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Esophagectomy

(Removal of the Esophagus)

En Español (Spanish Version)

Definition

Esophagectomy is the surgical removal of the esophagus, the tube that runs from your mouth to your stomach.

Parts of the Body Involved

  • Esophagus
  • Neck
  • Abdomen

Reasons for Procedure

Esophagectomy may be used to treat:

  • Esophageal cancer
  • Benign tumors and cysts of the esophagus
  • Other esophageal abnormalities

Esophageal Cancer

Esophageal cancer

© 2008 Nucleus Medical Art, Inc.

Risk Factors for Complications During the Procedure

What to Expect

Prior to Procedure

Your doctor will likely do the following:

  • Physical exam
  • Blood tests
  • Urine tests
  • Chest x-ray—a test that uses radiation to take pictures of structures inside the body, especially bones
  • Ultrasound—a test that uses sound waves to find tumors
  • CT scan—a type of x-ray that uses a computer to take pictures of structures in the body
  • MRI scan—a test that uses magnetic waves to make pictures of structures in the body
  • Upper endoscopy—a thin, lighted tube inserted down the throat to examine the esophagus
  • Placement of a feeding tube into your small intestine may also be done during the operation.

In the days leading up to your procedure, your doctor may recommend that you:

  • Review your medications with your surgeon. You may need to stop taking some of them.
  • Use an enema to clear your colon.
  • Follow a special diet.
  • Take antibiotics or other medications.
  • Shower the night before your procedure using antibacterial soap.
  • Arrange to have someone drive you to and from the procedure, and for help at home after your procedure.
  • Eat a light meal the night before, and do not eat or drink anything after midnight.
  • Wear comfortable clothing the day of your procedure.

Anesthesia

General anesthesia will be used. You will be asleep for the duration of the procedure. A tube will be placed in your windpipe to help you breathe.

Description of the Procedure

The surgeon will make one large or several small incisions in your abdomen or neck, depending where the mass to be removed is located.

  • In the case of one large incision, the surgeon will locate and remove the mass.
  • In a robot-assisted procedure, several small incisions will be made. A tiny camera and small surgical instruments will be inserted through the incisions. Looking at your esophagus on a monitor, the surgeon will locate and remove a portion of your esophagus.

A "replacement" esophagus will then be formed with your stomach. The remainder of your esophagus will be attached to this replacement esophagus. In some cases, associated lymph nodes will also be removed. One or more chest tubes will be placed into your side to drain fluids. Finally, the incision will be closed with stitches or staples.

After Procedure

The tissues that were removed will be sent to a pathologist for examination.

How Long Will It Take?

The procedure takes approximately six hours.

Will It Hurt?

You will feel some pain as the anesthesia wears off, but it can be managed with pain medications.

Possible Complications

  • Infection
  • Bleeding
  • Complications from anesthesia
  • Leaks from the internal suture line
  • Pneumonia
  • Abnormal heart rhythms
  • Heart attack
  • Death

Average Hospital Stay

The recovery time in th hospital is typically 1-2 weeks.

Postoperative Care

You will receive instruction from your doctor about your diet and activities, which will likely include daily walking. You will not be able to eat or drink anything during the first week after surgery; you will receive nutrition through the feeding tube. Within 7-14 days, you will have a swallowing test to check for areas of leaking fluid. If there are no leaks, your diet will gradually progress from clear liquid to soft, solid meals.

It is important to practice coughing and deep breathing exercises after your surgery. You may also be given an incentive spirometer, which is a breathing exercise device.

You will be prescribed medications to manage pain and given instructions on how to take care of your incision.

Outcome

Recovery time from an esophagectomy varies. You will probably be able to return to normal activities and a normal diet (usually in smaller quantities due to a smaller stomach) after about a month. You will be instructed to avoid heavy lifting for 6-8 weeks after your surgery.

Call Your Doctor If Any of the Following Occurs

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or discharge from an incision site
  • Persistent pain

RESOURCES:

American Cancer Society
http://www.cancer.org/

National Cancer Institute
http://www.cancer.gov/

CANADIAN RESOURCES:

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

National Cancer Institute of Canada
http://www.ncic.cancer.ca/

References:

Esophageal cancer—esophagectomy. University of Maryland Medical Center website. Available at: http://www.umm.edu/thoracic/esoph_surgery.html . Accessed March 1, 2007.

Ivor Lewis esophagectomy. Roswell Park Cancer Institute website. Available at: http://www.roswellpark.org/Patient_Care/Types_of_Cancer/Esophageal/Esophageal_Center_Patient_Handbook/Ivor_Lewis_Esophagectomy . Accessed March 1, 2007.

Robot-assisted thoracic procedures PIB. Health Library website. Available at: http://healthlibrary.epnet.com/GetContent.aspx?account=hotk2 . Accessed March 1, 2007.



Last reviewed February 2008 by Rosalyn Carson-DeWitt, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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