Esophagectomy Surgery

Overview

Esophagectomy is a surgical procedure to remove part or all of the esophagus, the tube connecting the mouth to the stomach. The surgery may also involve reconstructing the esophagus using tissues from other parts of the body, such as the stomach. This procedure is primarily performed to treat:

Advanced esophageal cancer
Barrett’s esophagus (precancerous condition)
End-stage achalasia with strictures

Alternate Name

Transhiatal Esophagectomy
Ivor Lewis Esophagectomy

Body Location

Behind the trachea in the thorax

Preparation for Esophagectomy

Before surgery, doctors will perform imaging tests like CT, MRI, and endoscopy with biopsies to assess the condition and decide the best approach. Preparation steps include:

Reviewing medical history, lifestyle habits, and allergies with the doctor.
Stopping food or drink before surgery to prevent aspiration.
Switching to a liquid diet 1-2 days before surgery, if advised.

On the day of surgery, you’ll receive anesthesia to ensure comfort during the procedure.

How Esophagectomy is Performed

The surgeon may use one of the following approaches:

Open Esophagectomy:
- A large incision is made in the chest or abdomen.
- The affected part of the esophagus, stomach, and lymph nodes are removed.
- The stomach is repositioned and connected to the remaining esophagus.
Robotic-Assisted Esophagectomy:
- Small incisions are made in the chest or abdomen.
- The surgeon uses robotic instruments and a camera to remove and reconnect the esophagus.

Recovery and Follow-Up

Post-surgery, patients typically:

Require a feeding tube for a few weeks while the esophagus heals.
Transition from liquid to soft foods before returning to solid meals.
Follow a diet plan of smaller, more frequent meals to accommodate a reduced stomach size

Risks Associated with Esophagectomy

Bleeding
Pneumonia or infections
Leakage at the stomach-esophagus connection
Blood clots
Swallowing difficulties
Voice changes

Recovery Tips

Follow dietary recommendations, including small, frequent meals.
Practice breathing exercises to support lung health.
Take prescribed pain medications.
Address swallowing issues or heartburn with doctor-recommended solutions.
Incorporate nutritional supplements to prevent weight loss.
Seek psychological support if needed during recovery.

FAQs About Esophagectomy

Can I eat normally after esophagectomy?
Initially, a liquid diet is followed by a gradual return to solid foods with portion adjustments.
How long is the recovery time?
Recovery varies but generally takes a few weeks to months to resume daily activities.
Will I need a hospital stay?
Yes, typically for 7-14 days, depending on recovery progress and the surgical method used.
How painful is esophagectomy?
Pain and discomfort are expected after surgery but are managed with prescribed medications.
What dietary changes are necessary?
Consume small, frequent meals, avoid spicy/acidic foods, chew thoroughly, and eat in an upright position.
Can the surgery be performed minimally invasively?
Yes, minimally invasive or robotic-assisted techniques are available, reducing recovery time and post-op pain.
Are there alternatives to esophagectomy?
Alternatives include radiation therapy, chemotherapy, endoscopic treatments, or targeted therapies, depending on the condition.

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