Esophagectomy is a major operation in which all or part of the esophagus is removed. It is performed mostly to treat esophageal cancer and, rarely, severe benign disease. Its aim is to remove the local disease and rebuild the pathway for food.
The operation is done under general anesthesia, by open surgery, keyhole surgery or with robotic assistance, depending on the tumor's location and the patient's condition. After the affected section and nearby lymph nodes are removed, the pathway is rebuilt by shaping the stomach into a tube and drawing it upward, or sometimes by using a piece of colon, which is joined to the remaining esophagus.
Surgery often takes four to eight hours, followed by days in intensive care and a hospital stay of one to two weeks. Feeding is first given through a tube, then eating is introduced gradually. Recovery and adjustment to the new way of eating can take weeks to months, and no specific result can be guaranteed.
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The operation may remove the tumor or damaged section, relieve esophageal blockage and improve swallowing. A cure cannot be promised, because the effect depends on the type and stage of the disease and on the patient's condition.
The decision depends on the type and stage of the disease and on the health of the heart, lungs and nutrition. After tests and imaging, the treating team decides whether surgery is suitable and whether other treatments are needed before or after it.
Blood tests, a CT scan, endoscopy and heart and lung checks are usually done. Nutrition is improved, smoking is stopped and obesity is addressed if present. Your doctor will advise you about medicines and fasting.
The diseased part of the esophagus is removed together with lymph nodes, and a tube made from the stomach is raised into the chest or neck to take its place. It may be done by keyhole surgery, with robotic assistance or by the open method.
In the first days feeding is given through a tube or a vein, then you begin with liquids and gradually move to soft foods. Small, frequent meals and dietary guidance are usually needed.
It usually includes a short stay in intensive care, breathing exercises, early walking and a hospital stay of about one to two weeks. Regaining energy and weight may take several months, with regular nutritional follow-up.
Some patients experience early fullness, acid reflux and difficulty eating, and may find it hard to sleep lying flat. These symptoms often ease with well-organized meals, raising the head during sleep and following the doctor's advice.
They include leakage or narrowing at the join, pneumonia, bleeding, infection, irregular heartbeat and hoarseness. This is major surgery, and the surgeon will explain the risks that apply to your case.
In many cancer cases the treating team recommends chemotherapy, radiotherapy or other treatment before or after surgery, depending on the stage of the disease and the tissue test results.
Travel is not advised before you leave hospital and your condition and eating are stable, which often means staying at least two to three weeks. The treating doctor confirms the date after examination.
