Esophagectomy is a procedure to remove part or all of the esophagus. The esophagus is the tube that runs from the mouth to the stomach.
Reasons for Procedure
Esophagectomy may be used to treat:
- Esophageal cancer
- Benign tumors and cysts of the esophagus
- Other esophageal abnormalities such as achalasia or Barrett esophagus
- Severe trauma
Problems from the procedure can occur, but all procedures have some risk. Your doctor will review potential problems, like:
- Blood clots
- Soreness in throat
- Adverse reaction to the anesthesia
- Leaks from the internal suture line, which may cause scarring and need for dilations
- Heart attack
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications, such as:
What to Expect
Prior to Procedure
Your doctor will likely do the following:
- Physical exam
- Blood and urine tests
- Chest x-ray
- CT scan
- MRI scan
- Upper endoscopy
- Place a feeding tube into your small intestine (may be done during the esophagectomy)
Leading up to your procedure:
- Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure
- Arrange for someone to drive you home from the hospital and to help you 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.
General anesthesia will be used. You will be asleep during the procedure.
Description of the Procedure
Depending on the area that needs to be removed, the doctor will make an incision in the neck, chest, or abdomen using one of these techniques:
- An open procedure using one large incision. The diseased area will be located and removed.
- A laproscopic procedure that uses several small incisions. A tiny camera and small surgical instruments will be inserted through the incisions. Looking at the esophagus on a monitor, the doctor will locate and remove the diseased area.
- A robot-assisted procedure.
A replacement esophagus will be 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 also be removed. One or more chest tubes will be placed to drain fluids. Lastly, the incisions will be closed with stitches or staples.
How Long Will It Take?
About 6 hours
How Much Will It Hurt?
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
Average Hospital Stay
This procedure is done in a hospital setting. The usual length of stay is 1-2 weeks. Your doctor may choose to keep you longer if complications arise.
You will not be able to eat or drink anything 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 there are no leaks, your diet will gradually progress from clear liquids to soft, solid meals. You will probably be able to return to a normal diet after about 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 breath deeply.
During your stay, the hospital staff will take steps to reduce your chance of infection, such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
There are also steps you can take to reduce your chance of infection, such as:
- Washing your hands often and reminding your healthcare providers to do the same
- Reminding your healthcare providers to wear gloves or masks
- Not allowing others to touch your incision
You will need to restrict your activities, including heavy lifting, for 6-8 weeks. Follow instructions on home exercises to promote healing. Monitor your incision for infection. Follow instructions on cleaning and changing the dressing.
Call Your Doctor
It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor:
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
- Persistent nausea and/or vomiting
- Pain that you cannot control with the medications you've been given
- Cough, shortness of breath, or chest pain
- Constipation or diarrhea
- Pain and/or swelling in your feet, calves, or legs
- Trouble swallowing
If you think you have an emergency, call for medical help right away.
- Reviewer: Michael Woods, MD
- Review Date: 05/2016 -
- Update Date: 05/23/2014 -