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 Clinic, 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.
An important aspect of esophagectomy is determining which type of the procedure is best for you. To guide that decision, Mayo Clinic 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.
Typically, you'll have preoperative medical testing that may include a heart (cardiac) evaluation to check for cardiovascular disease, which could complicate surgery.
Before esophagectomy, Mayo Clinic doctors may recommend chemotherapy or radiation or both, followed by a period of recovery.
Your Mayo Clinic 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.
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:
May 13, 2015
- 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
- Delaney CP. Esophagectomy. In: Netter's Surgical Anatomy and Approaches. Philadelphia, Pa.: Saunders Elsevier; 2014. http://www.clinicalkey.com. Accessed April 24, 2015.
- Jaroszewski DE, et al. An early experience using the technique of transoral OrVil EEA stapler for minimally invasive transthoracic esophagectomy. Annals of Thoracic Surgery. 2011;92:1862.
- Parker M, et al. Transcervical videoscopic esophageal dissection during two-field minimally invasive esophagectomy: Early patient experience. Surgical Endoscopy. 2011;25:3865.
- Cook AJ. Decision Support System. Mayo Clinic, Rochester, Minn. April 24, 2015.
- Wright CD, et al. Management of superficial esophageal cancer. http://www.uptodate.com/home. Accessed April 24, 2015.
- Palazzo F, et al. Minimally invasive esophagectomy provides significant survival advantage compared with open or hybrid esophagectomy for patients with cancers of the esophagus and gastroesophageal junction. Journal of the American College of Surgeons. 2015;220:672.
- Sarkaria IS, et al. Robotic-assisted minimally invasive esophagectomy: The Ivor Lewis Approach. Thoracic Surgery Clinics. 2014;24:211.