An esophagectomy is a surgery to remove part or all of the esophagus (the tube through which food travels from the throat to the stomach). It is most often performed for esophageal cancer. The types of esophagectomy and the details of the procedure are discussed.
An esophagectomy is a surgery to remove part or all of the esophagus (the tube through which food travels from the throat to the stomach). It is most often performed for esophageal cancer, a condition in which malignant (cancerous) tumors develop in the esophagus. It may also be performed for benign (nonmalignant) diseases of the esophagus where the esophageal function has deteriorated to the point that the individual can no longer swallow.
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There are several different approaches (surgical methods) for an esophagectomy, depending on the number of incisions (cuts) and where the incisions are made. This is determined by several factors, including where the tumor is located, if the patient has had an earlier surgery, and the preference of the surgeon.
The surgical approaches include the following:
Regardless of the type of esophagectomy, a jejunostomy tube (feeding tube) is placed as part of the esophagectomy. This is used to provide nutrition for up to 30 days after the surgery as the patient recovers his or her swallowing function.
The patient will also have a nasogastric tube, a drain that goes in through the nose. This tube is essential for keeping the stomach decompressed in order to give the new connection from the esophagus to the stomach a better chance to heal.
Before the surgery, the patient is given anesthesia to put him or her to sleep during the operation. An epidural catheter may be placed into the back before the patient goes to sleep in order to aid in postoperative (after the surgery) pain control.
After an esophagectomy, the patient is taken to the intensive care unit (ICU) for 24-48 hours. He or she will be weaned off the ventilator and started on tube feeds, and the epidural will be adjusted to optimize (maximize) pain control.
The patient is then transferred to the floor where he or she is transitioned to liquid pain medication that can be placed down the feeding tube. The drains and the epidural are eventually removed, and the patient is encouraged to walk. In this phase of care, the patient will be seen by the surgical team, respiratory therapists, physical therapists and social work in order to prepare for discharge to home.
The main risks of an esophagectomy include:
After an esophagectomy, follow these steps:
After an esophagectomy, call your doctor if you:
You should also call your doctor if you have:
Last reviewed by a Cleveland Clinic medical professional on 03/04/2019.
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