Esophagectomy - open
Alternative Names: Trans-hiatal esophagectomy; Trans-thoracic esophagectomy; En bloc esophagectomy; Removal of the esophagus - open; Ivor-Lewis operation
An esophagectomy is surgery to remove part or all of the esophagus, 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 of Procedure
There are many ways to do this surgery. Talk with your doctor about what 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. See also: Esophagectomy - minimally invasive
Open surgery is another way to do an esophagectomy. Two ways to do an esophagectomy using open surgery are:
Trans-hiatal esophagectomy:
- Your surgeon will make two large cuts, one in your neck area and one in your upper belly.
- Your surgeon will close off one part of your stomach with staples and cut this section off. This part of your stomach will be used to form a new tube to replace the part of your esophagus that is removed.
- Your surgeon will remove the part of your esophagus where the cancer or other problems are.
- Your surgeon will join together your rebuilt esophagus and stomach in your neck.
- Lymph nodes in your neck and chest may also be removed if cancer has spread to them.
- Your surgeon will place a feeding tube in your small intestine so that you can be fed while you are recovering from the surgery.
Trans-thoracic esophagectomy:
- Your surgeon will make two cuts, one in your right chest and one in your upper belly.
- Your surgeon will close off one part of your stomach with staples and cut this section off. This part of your stomach will be used to form a new tube to replace the part of your esophagus that is cut out.
- Your surgeon will remove the part of your esophagus where the cancer or other problems are.
- Your surgeon will join together your rebuilt esophagus and stomach in your neck or chest.
- Lymph nodes in your neck and chest may also be removed if cancer has spread to them.
- Your surgeon will place a feeding tube in your small intestine so that you can be fed while you are recovering from the surgery.
Your 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.
- To do it, your surgeon will make large cuts in your neck, chest, and belly. All of your esophagus and part of your stomach will be removed.
- The rest of your stomach will be reshaped into a tube and placed in your chest to replace your esophagus. The stomach tube will be connected to the remnant of the esophagus in the neck.
- Your surgeon will also remove all lymph nodes in your chest and belly.
Most of these operations take about 3 - 6 hours.
Risks of Esophagectomy - open
Esophagectomy is major surgery and has many possible risks. Some of them are serious. You should discuss these risks with your surgeon.
The risks from this surgery, or for problems after surgery, may be greater than normal if:
- You are unable to walk, even for short distances (this increases the risk of blood clots, lung problems, and pressure sores)
- You are still growing
- You are older than 60 - 65
- You are a heavy smoker
- You are obese
- You have lost a lot of weight from your cancer
- You are on corticosteroids
Risks for any anesthesia are:
- Allergic reactions to medicines
- Breathing problems
Risks for any surgery are:
- Blood clots in the legs that may travel to the lungs
- Blood loss
- Heart attack or stroke during surgery
- Infection, including in the surgical wound, lungs (pneumonia), bladder, or kidney
Risks for this surgery are:
- Acid reflux
- Injury to the stomach, intestines, lungs, or other organs during surgery
- Leakage of the contents of your esophagus or stomach where the surgeon joined them together
- Narrowing of the connection between your stomach and esophagus
Learn more about Esophagectomy - open
Reviewed By: Shabir Bhimji, MD, PhD, Specializing in General Surgery, Cardiothoracic and Vascular Surgery, Midland, TX. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
Copyright 2011 A.D.A.M., Inc.
