Esophagectomy
(Removal of the Esophagus)
Definition
Reasons for Procedure
- Esophageal cancer
- Benign tumors and cysts of the esophagus
- Other esophageal abnormalities
| Esophageal Cancer |
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Possible Complications
- Bleeding
- Blood clots
- Infection
- Soreness in throat
- Adverse reaction to the anesthesia
- Leaks from the internal suture line
- Heart attack
- Pre-existing heart or lung conditions
- Advanced age
- Obesity
- Smoking
- Diabetes
- Excessive alcohol intake
What to Expect
Prior to Procedure
- Physical exam
- Blood and urine tests
- Chest x-ray —a test that uses radiation to take pictures of structures inside the body
- Ultrasound—a test that uses sound waves to examine structures in the body
- CT scan —a type of x-ray that uses a computer to take pictures of structures in the body
- MRI scan —a test that uses magnetic waves to make pictures of structures in the body
- Upper endoscopy —a thin, lighted tube inserted down the throat to examine the esophagus
- Place a feeding tube into your small intestine (may be done during the esophagectomy)
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Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
- Anti-inflammatory drugs (eg, aspirin )
- Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)
- Arrange 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.
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Your doctor may ask you to:
- Use an enema to clear your intestines
- Follow a special diet.
- Take antibiotics or other medicines.
- Shower using antibacterial soap the night before the surgery.
Anesthesia
Description of the Procedure
- One large incision (open procedure)—The doctor will locate the diseased area and remove it.
- Several small incisions ( robot-assisted procedure )—A tiny camera and small surgical instruments will be inserted through the incisions. Looking at the esophagus on a monitor, the doctor will locate and remove the diseased area.
How Long Will It Take?
How Much Will It Hurt?
Average Hospital Stay
Post-procedure Care
- Your doctor will encourage you to walk every day.
- Avoid heavy lifting for 6-8 weeks.
- Ask your doctor about when it is safe to shower, bathe, or soak in water.
Call Your Doctor
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
- Nausea and/or vomiting that you cannot control with the medicines you were given after surgery, or which persist for more than two days after discharge from the hospital
- Pain that you cannot control with the medicines you have been given
- Pain, burning, urgency or frequency of urination, or persistent bleeding in the urine
- Cough, shortness of breath, or chest pain
- Constipation or diarrhea
- Pain and/or swelling in your feet, calves, or legs
RESOURCES
American Cancer Society http://www.cancer.org/
National Cancer Institute http://www.cancer.gov/
CANADIAN RESOURCES
Canadian Cancer Society http://www.cancer.ca/
National Cancer Institute of Canada http://www.ncic.cancer.ca/
References
Esophageal cancer—esophagectomy. University of Maryland Medical Center website. Available at: http://www.umm.edu/thoracic/esoph%5Fsurgery.html . Accessed March 1, 2007.
Ivor Lewis esophagectomy. Roswell Park Cancer Institute website. Available at: http://www.roswellpark.org/Patient%5FCare/Types%5Fof%5FCancer/Esophageal/Esophageal%5FCenter%5FPatient%5FHandbook/Ivor%5FLewis%5FEsophagectomy . Accessed March 1, 2007.
Robot-assisted thoracic procedures PIB. Health Library website. Available at: http://healthlibrary.epnet.com/GetContent.aspx?account=hotk2 . Accessed March 1, 2007.
