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.
Esophagectomy may be used to treat: Esophageal cancerBenign tumors and cysts of the esophagus
Other esophageal abnormalities
Barrett esophagusSevere trauma
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Problems from the procedure can occur, but all procedures have some risk. Your doctor will review potential problems, like: BleedingBlood clotsInfectionSoreness in throatAdverse reaction to the anesthesiaLeaks from the internal suture line, which may cause scarring and need for dilationsHeart attack
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications, such as: SmokingDrinking
Chronic diseases, such as
Your doctor will likely do the following: Physical examBlood and urine testsChest x-rayUltrasoundCT scanMRI scanUpper endoscopyPlace 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 1 week before the procedureArrange 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 intestinesFollow a special diet.Take antibiotics or other medications.Shower using antibacterial soap the night before the surgery.
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 1 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 diseased area will be located and removed.
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. 1 or more chest tubes will be placed to drain fluids.
Lastly, the incisions will be closed with stitches or staples.
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
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
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 handsWearing gloves or masksKeeping 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 sameReminding your healthcare providers to wear gloves or masksNot allowing others to touch your incision
Home care includes: Avoiding heavy lifting for 6-8 weeksDoing home exercisesFollowing your doctor's instructions
Contact your doctor if your recovery is not progressing as expected or you develop complications such as: Signs of infection, including fever and chillsRedness, swelling, increasing pain, excessive bleeding, or any discharge from the incision sitePersistent nausea and/or vomitingPain that you cannot control with the medications you've been givenCough, shortness of breath, or chest painConstipation or diarrheaPain and/or swelling in your feet, calves, or legsTrouble swallowing
If you think you have an emergency, call for medical help right away.
Esophagectomy. Boston Medical Center website. Available at:
http://www.bmc.org/esophagealtherapies/treatments/esophagectomy.htm. Accessed May 6, 2016.
Esophagectomy. Massachusetts General Hospital website. Available at:
http://www.massgeneral.org/digestive/services/procedure.aspx?id=2296. Accessed May 6, 2016.
Esophagectomy. Memorial Hermann website. Available at:
http://www.memorialhermann.org/digestive/esophagectomy. Accessed May 6, 2016.
Esophagectomy. University of California San Francisco website. Available at:
http://surgery.ucsf.edu/conditions--procedures/esophagectomy.aspx. Accessed May 6, 2016.
Surgical removal of the esophagus (esophagectomy). UC Davis Health System website. Available at:
http://www.ucdmc.ucdavis.edu/surgery/specialties/cardio/esophagus.html. Accessed May 6, 2016.
Last reviewed June 2016 by Michael Woods, 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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