Wentworth-Douglass Hospital
(603) 742-5252
Decrease (-) Restore Default Increase (+) font size
Physicians
Health Library
Back to Health Library   Print This Page Print    Email to a Friend Email

Definition:

An esophagectomy is surgery to remove part or all of the esophagus, the tube that moves food from your throat to your stomach. After it is removed, the esophagus is rebuilt from part of your stomach or part of your large intestine.

Most of the time, esophagectomy is done to treat cancer of the esophagus .



Alternative Names:

Trans-hiatal esophagectomy; Trans-thoracic esophagectomy; En bloc esophagectomy; Removal of the esophagus - open



Description:

There are many ways to do this surgery. Talk with your doctor about what type of surgery is best for you. It will depend on where in your esophagus your cancer is, how much it has spread, and how healthy you are.

Laparoscopy is one way to do this surgery. A laparoscope is a tiny camera that is inserted into your belly through a small incision. See also: Esophagectomy - minimally invasive

Open surgery is another way to do an esophagectomy. Two ways to do an esophagectomy using open surgery are:

Trans-hiatal esophagectomy:

  • Your surgeon will make 2 large incisions (cuts), one in your neck area and one in your upper belly.
  • Your surgeon will close off part of your stomach with staples and cut this section off. This part of your stomach will be used to form a new section of your esophagus. It will replace the part of your esophagus that will be removed.
  • Your surgeon will remove the part of your esophagus where your cancer or other problems are.
  • Your surgeon will join together your rebuilt esophagus and stomach in your neck.
  • Lymph nodes in your neck and chest may also be removed if your cancer has spread to them.

Trans-thoracic esophagectomy:

  • Your surgeon will make 2 incisions, one in your chest and one in your upper belly.
  • Your surgeon will close off part of your stomach with staples and cut this section off. This part of your stomach will be used to form a new section of your esophagus. It will replace the part of your esophagus that will be removed.
  • Your surgeon will remove the part of your esophagus where your cancer or other problems are.
  • Your surgeon will join together your rebuilt esophagus and stomach in your neck.
  • Lymph nodes in your neck and chest may also be removed if your cancer has spread to them.

Your surgeon may also examine and do a biopsy of the lymph nodes in your belly to see if your cancer has spread to them.

En bloc esophagectomy is another type of esophagectomy. It is the most invasive of all of these procedures.

  • To do it, your surgeon will make large cuts in your chest and belly. All of your esophagus and part of your stomach will be removed.
  • The rest of your stomach will be reshaped and placed in your chest to replace your esophagus.
  • Your surgeon will also remove all lymph nodes in your chest and belly.

Most of these operations take about 3 hours.



Why the Procedure Is Performed:

The most common reason for removing part, or all, of your esophagus is to treat cancer. You may also have radiation therapy or chemotherapy before or after surgery.

Surgery to remove the lower part of your esophagus may also be done to treat:

  • Pre-cancerous changes in the tissue of your esophagus. This condition is called high-grade dysplasia.
  • Achalasia , a condition where the esophagus doesn’t work well


Risks:

Esophagectomy is major surgery and has many possible risks. Some of them are serious. You should discuss these risks with your surgeon.

The risks from this surgery, or for problems after surgery, may be greater than normal if:

  • You are unable to walk even for short distances. This increases the risk of blood clots, lung problems, and pressure sores.
  • You are an older child who is still growing.
  • You are older than 60 to 65.
  • You are a heavy smoker.

Risks for any anesthesia are:

Risks for any surgery are:

Risks for this surgery are:

  • Injury to the stomach, intestines, lungs, or other organs during surgery
  • Leakage of the contents of your esophagus or stomach where the surgeon joined them together
  • Narrowing of the connection between your stomach and esophagus


Before the Procedure:

You will have many doctor visits and medical tests before you have this surgery. Some of these are:

  • A complete physical examination
  • Visits with your doctor to make sure other medical problems you may have, such as diabetes , high blood pressure , and heart or lung problems, are under control
  • Nutritional counseling
  • A visit or class to learn what happens during the surgery, what you should expect afterward, and what risks or problems may occur afterward

If you are a smoker, you should stop several weeks before the surgery. Your doctor or nurse for can help.

Always tell your doctor or nurse:

  • If you are or might be pregnant
  • What drugs, vitamins, and other supplements you are taking, even ones you bought without a prescription
  • If you have been drinking a lot of alcohol, more than 1 or 2 drinks a day

During the week before your surgery:

  • You may be asked to stop taking drugs that make it hard for your blood to clot. Some of these are aspirin, ibuprofen (Advil, Motrin), vitamin E, warfarin (Coumadin), and clopidogrel (Plavix),or ticlopidine (Ticlid).
  • Ask your doctor which drugs you should still take on the day of your surgery.
  • Prepare your home for after the surgery.

On the day of your surgery:

  • Do not eat or drink anything after midnight the night before your surgery.
  • Take the drugs your doctor told you to take with a small sip of water.
  • Your doctor or nurse will tell you when to arrive at the hospital.


After the Procedure:

Most people stay in the hospital for 7 to 14 days after an esophagectomy. How long you stay will depend on what type of surgery you had. You may spend 1 to 3 days in the intensive care unit (ICU) right after surgery.

You will stay in the hospital for 10 to 14 days after en bloc esophagectomy

During your hospital stay, you will:

  • Be asked to sit on the side of your bed and walk on the same day you had surgery
  • Not be able to eat for at least the first 2 to 3 days after surgery. After that, you will begin with liquids. You will be fed through a feeding tube that goes into your intestine.
  • Have a tube coming out of the side of your chest to drain fluids that build up
  • Wear special stockings on your feet and legs to prevent blood clots
  • Receive shots to prevent blood clots
  • Receive pain medicine through an IV or take pills. You may receive your pain medicine through a special pump. With this pump, you press a button to deliver pain medicine when you need it. This allows you to control the amount of pain medicine you get.
  • Do breathing exercises


Outlook (Prognosis):

Many people recover well from this surgery and can eat a fairly normal diet after they recover. Talk with your doctor about the best way to treat your cancer.



References:

Maish M. Esophagus. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 41.




Review Date: 2/17/2009
Reviewed By: Robert A. Cowles, MD, Assistant Professor of Surgery, Columbia University College of Physicians and Surgeons, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
adam.com


Find What You Need

Events
Careers
Foundation
About Us
Contact
Directions
News
Social Media Agreement
Joint Notice
Web Privacy Policy
WDH Staff Portal

Centers & Services

Cancer Center
Cardiovascular Care
Joint Replacement
Women & Children's
Physician Offices
Other Services

Conditions & Treatments

Health Library

Support Services

Support Groups
Care-Van
Dental Center
Social Work
Food & Nutrition
Integrative Wellness
Spiritual Care
Concerns & Grievances
Homecare and Hospice

For Patients

Pay Your Bill Online
Pricing Estimates
Financial Assistance
Interpreter Services
Surgery Preparation
Medical Record Request
Advance Directives
Clinical Research & Trials

For Healthcare Professionals

Work and Life
Financial Well-Being
Career and Growth

The Wentworth-Douglass Health System includes:

 

Address

Wentworth-Douglass Hospital
789 Central Avenue, Dover, NH 03820
Phone: (603) 742-5252
Toll free: 1 (877) 201-7100