Treatment at Mayo Clinic

By Mayo Clinic Staff

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
Nov. 10, 2010