Definition of Esophagectomy - open:

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.

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 the 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 surgical cut. 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 two large cuts, one in your neck area and one in your upper belly.
• Your surgeon will close off one part of your stomach with staples and cut this section off. This part of your stomach will be used to form a new tube to replace the part of your esophagus that is removed.
• Your surgeon will remove the part of your esophagus where the 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 cancer has spread to them.
• Your surgeon will place a feeding tube in your small intestine so that you can be fed while you are recovering from the surgery.

Trans-thoracic esophagectomy:

• Your surgeon will make two cuts, one in your right chest and one in your upper belly.
• Your surgeon will close off one part of your stomach with staples and cut this section off. This part of your stomach will be used to form a new tube to replace the part of your esophagus that is cut out.
• Your surgeon will remove the part of your esophagus where the cancer or other problems are.
• Your surgeon will join together your rebuilt esophagus and stomach in your neck or chest.
• Lymph nodes in your neck and chest may also be removed if cancer has spread to them.
• Your surgeon will place a feeding tube in your small intestine so that you can be fed while you are recovering from the surgery.

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

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

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

Most of these operations take about 3 - 6 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:

• Achalasia, a condition in which the esophagus doesn't work well
• Pre-cancerous changes in the tissue of your esophagus, called high-grade dysplasia (Barrett's esophagus)
• Severe trauma