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Esophagectomy - open

Trans-hiatal esophagectomy; Trans-thoracic esophagectomy; En bloc esophagectomy; Removal of the esophagus - open; Ivor-Lewis esophagectomy, Blunt esophagectomy; Esophageal cancer - esophagectomy - open; Cancer of the esophagus - esophagectomy - open

Open 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 or a severely damaged stomach.

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Description

During open esophagectomy, one or more large surgical cuts (incisions) are made in your belly, chest, or neck. (Another way to remove the esophagus is laparoscopically. Surgery is done through several small incisions, using a viewing scope.)

This article discusses three types of open surgery. With any surgery, you will receive medicine (anesthesia) that will keep you asleep and pain-free.

Transhiatal esophagectomy:

Transthoracic esophagectomy: This surgery is done in a similar way as the transhiatal procedure. But the upper cut is made in your right chest, not in the neck.

En bloc esophagectomy:

Most of these operations take 3 to 6 hours.

Why the Procedure Is Performed

Surgery to remove the lower esophagus may also be done to treat:

Risks

This is major surgery and has many risks. Some of them are serious. Be sure to discuss these risks with your surgeon.

Risks of this surgery, or for problems after surgery, may be greater than normal if you:

Risks for anesthesia and surgery in general are:

Risks for this surgery are:

Before the Procedure

You will have many doctor visits and medical tests before surgery, including:

If you are a smoker, you should stop smoking several weeks before surgery. Your health care provider can help.

Tell your provider:

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 this surgery. You may spend 1 to 3 days in the intensive care unit (ICU) right after surgery.

During your hospital stay, you will:

After you go home, follow instructions on how to take care of yourself as you heal. You'll be given information on diet and eating. Be sure to follow those instructions as well.

Outlook (Prognosis)

Many people recover well from this surgery and can have a normal diet. After they recover, they will likely have to eat smaller portions and eat more often.

If you had the surgery for cancer, talk with your doctor about the next steps to treat the cancer.

Related Information

Esophageal cancer
Esophagectomy - minimally invasive
Gastrostomy feeding tube - bolus
Clear liquid diet
Esophagectomy - discharge
Diet and eating after esophagectomy

References

National Cancer Institute website. Esophageal cancer treatment (PDQ) - health professional version. www.cancer.gov/types/esophageal/hp/esophageal-treatment-pdq. Updated January 29, 2019. Accessed February 25, 2019.

Spicer JD, Dhupar R, Kim JY, Sepesi B, Hofstetter W. Esophagus. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 41.

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Review Date: 1/31/2019  

Reviewed By: Mary C. Mancini, MD, PhD, Director, Cardiothoracic Surgery, Christus Highland Medical Center, Shreveport, LA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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