Esophagectomy is a surgical procedure to remove part of the tube between your mouth and stomach (esophagus) and then reconstruct it using part of another organ, usually the stomach. Esophagectomy is a common treatment for advanced esophageal cancer, and is used occasionally for Barrett's esophagus if precancerous cells are present.

Esophagectomy is the main surgical treatment for esophageal cancer. It is done either to remove the cancer or to relieve symptoms. During an esophagectomy, the surgeon removes all or part of the esophagus through an incision in the chest. The esophagus is reconstructed using another organ, most commonly the stomach but occasionally the large intestine.

Some esophagectomies can be done with minimally invasive surgery (laparoscopic surgery). The procedure is done through several small incisions and can result in reduced pain and faster recovery than conventional surgery. At Mayo, laparoscopic techniques include robot-assisted surgery (robotic surgery) and new procedures that access the esophagus through the throat and through small incisions in the abdomen and behind the collarbone.

Before surgery

An important aspect of esophagectomy is determining which type of the procedure is best for you. To guide that decision, Mayo specialists use state-of-the-art imaging techniques, such as CT, MRI and positron emission tomography (PET) imaging, as well as endoscopic ultrasound and fine-needle biopsies during endoscopy.

A heart (cardiac) evaluation may be done to check for cardiovascular disease that could complicate surgery.

Mayo doctors may recommend six weeks of chemotherapy or radiation or both, followed by six weeks of recovery, before an esophagectomy.

After surgery

Your Mayo doctor will likely recommend home enteral nutrition (tube feeding) for four to six weeks to ensure adequate nutrition while you recover. Once you resume a normal diet, the stomach's reduced size means you will need to eat smaller quantities. You may lose weight after surgery.

Follow-up care

Most people report improved quality of life after esophagectomy, but some symptoms usually continue. Mayo Clinic has comprehensive follow-up care to prevent complications after surgery and to help you adjust your lifestyle.

Follow-up care includes:

  • Lung therapy (pulmonary rehabilitation) to prevent breathing problems
  • Pain management to treat heartburn and problems with swallowing
  • Nutritional assessments to help with weight loss
  • Psychosocial care if needed
  • Experience. Mayo Clinic surgeons perform more than 150 esophagectomies each year. Studies have shown that people who had esophagectomies at low-volume centers had a much higher risk of dying from the operation than did people treated at high-volume centers (defined as more than 20 esophagectomies per year).
  • Teamwork. Esophagectomy is an important part of esophageal cancer treatment, which can be extremely complex. At Mayo, specialists in thoracic surgery, digestive diseases, oncology and other areas work together to manage your care, before and after surgery.
  • Minimally invasive approach. Mayo doctors can sometimes perform minimally invasive esophagectomies, which usually result in less pain, shorter hospital stays and faster recovery than traditional open surgery.
  • Efficient care. Consultations with doctors, testing and treatment can usually be done in a single visit lasting several days.
  • New ideas. Mayo specialists are at the forefront of new techniques for esophagectomy. You have access to the expertise of Mayo's clinician-researchers.

Mayo Clinic in Rochester, Minn., ranks No. 1 for digestive disorders in the U.S. News & World Report Best Hospitals rankings. Mayo Clinic in Scottsdale, Ariz., and Mayo Clinic in Jacksonville, Fla., are ranked high performing for digestive disorders by U.S. News & World Report. Mayo Clinic also ranks among the Best Children's Hospitals for digestive disorders.

At Mayo Clinic, we assemble a team of specialists who take the time to listen and thoroughly understand your health issues and concerns. We tailor the care you receive to your personal health care needs. You can trust our specialists to collaborate and offer you the best possible outcomes, safety and service.

Mayo Clinic is a not-for-profit medical institution that reinvests all earnings into improving medical practice, research and education. We're constantly involved in innovation and medical research, finding solutions to improve your care and quality of life. Your doctor or someone on your medical team is likely involved in research related to your condition.

Our patients tell us that the quality of their interactions, our attention to detail and the efficiency of their visits mean health care — and trusted answers — like they've never experienced.

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What Sets Mayo Clinic Apart

Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

Specialists in cardiothoracic surgery provide esophagectomy treatment.

For appointments or more information, call the Central Appointment Office at 800-446-2279 (toll-free) 8 a.m. to 5 p.m. Mountain Standard Time, Monday through Friday or complete an online appointment request form.

Specialists in cardiothoracic surgery provide esophagectomy treatment.

For appointments or more information, call the Central Appointment Office at 904-953-0853 8 a.m. to 5 p.m. Eastern time, Monday through Friday or complete an online appointment request form.

Specialists in thoracic surgery provide esophagectomy treatment.

For appointments or more information, call the Central Appointment Office at 507-538-3270 7 a.m. to 6 p.m. Central time, Monday through Friday or complete an online appointment request form.

See information on patient services at the three Mayo Clinic locations, including transportation options and lodging.

Mayo Clinic researchers are working to improve treatment with esophagectomy. Studies cover a wide range of areas, including less invasive laparoscopic techniques, the complications of esophagectomy generally and specifically for people who had previous anti-reflux surgery, and the role of esophagectomy in treating Barrett's esophagus with high-grade dysplasia.

Publications

See a list of publications by Mayo Clinic doctors on esophagectomy on PubMed, a service of the National Library of Medicine.

Nov. 10, 2010