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Esophagectomy - open

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An esophagectomy is surgery to remove part or all of the esophagus. This is 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 which 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.

Open surgery is another way to do an esophagectomy. Two ways to do an esophagectomy using open surgery are:

Trans-hiatal esophagectomy: Trans-thoracic esophagectomy: The 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. Most of these operations take about 3 to 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:
Risks
Esophagectomy is major surgery and has many possible risks. Some of them are serious. You should discuss these risks with your surgeon.

Risks of this surgery, or for problems after surgery, may be greater than normal if: Risks of any anesthesia are: Risks of any surgery are: Risks of this surgery are:
Before the Procedure
You will have many doctor visits and medical tests before you have surgery. Some of these are: If you are a smoker, you should stop smoking several weeks before surgery. Your doctor or nurse can help.

Tell your doctor or nurse: During the week before surgery: On the day of surgery:
After the Procedure
Most people stay in the hospital for 7 to 14 days after an esophagectomy. How long you stay will depend on what type of surgery you had. You may spend 1 to 3 days in the intensive care unit (ICU) right after surgery.

You will stay in the hospital for 10 to 14 days after en bloc esophagectomy

During your hospital stay, you will:
Outlook (Prognosis)
Many people recover well from this surgery and can eat a fairly normal diet after they recover. Talk with your doctor about the best way to treat cancer.

Alternative Names
Trans-hiatal esophagectomy; Trans-thoracic esophagectomy; En bloc esophagectomy; Removal of the esophagus - open; Ivor-Lewis operation

References
Maish M. Esophagus. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 43.

National Cancer Institute: PDQ esophageal cancer treatment. Bethesda, MD: National Cancer Institute. Date last modified 2/15/2013. Available at:http://www.cancer.gov/cancertopics/pdq/treatment/esophageal/HealthProfessional. Accessed February 20, 2013.

Update Date: 2/6/2013
Matthew M. Cooper, MD, FACS, Medical Director, Cardiovascular Surgery, HealthEast Care System, St. Paul, MN. Review provided by VeriMed Healthcare Network. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.
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