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An esophagectomy

is surgery to remove part or all of your esophagus. An esophagectomy is usually done if you have been diagnosed with cancer of the esophagus. It can also be done if your esophagus does not work properly or has severe damage or trauma. You may need to stay in the hospital for up to 2 weeks.

Prepare for an esophagectomy:

Your healthcare provider will talk to you about how to prepare for surgery. He will tell you not to eat or drink anything after midnight on the day of your surgery. He will tell you what medicines to take or not take on the day of your surgery.

What will happen during an esophagectomy:

  • You will be given general anesthesia to keep you asleep and pain-free during your surgery. Surgery may be done through small incisions and a tool called a laparoscope. You may have open surgery instead of laparoscopic surgery. Open surgery means removing and replacing your esophagus through large incisions.
  • The diseased part of your esophagus will be removed. It will then be replaced by your stomach or part of your large intestines. Your healthcare provider may also remove lymph nodes. During surgery, your healthcare provider will insert a feeding tube into your small intestine. He will also place a nasogastric or gastric tube to help the stitches heal.

What will happen after an esophagectomy:

You may stay in the hospital for up to 2 weeks after surgery.

  • You may have chest tubes in place. You may also have a gastric tube coming from your abdomen. Both tubes will be attached to suction and will help with healing. You may have smaller drains to prevent swelling around your incision.
  • You will not be able to eat or drink for a period of time after surgery. You will be fed through your feeding tube until you are able to eat and drink. You will be sent home with your feeding tube in place. Ask your healthcare provider for information about your feeding tube.

Risks of an esophagectomy:

You may bleed more than expected or develop an infection. Fluid may leak into your chest or abdomen. Your vocal cords may become paralyzed. You may have difficulty swallowing. Food may move too quickly or slowly into your intestines. You may feel full quickly or vomit when you eat. Reflux is also a risk. Reflux is when fluid backs up from your stomach into your esophagus.

Prevent reflux:

  • Sit up when you eat or drink. Remain sitting up at least 30 minutes after your meal.
  • Drink liquids between meals. Do not drink liquids with meals unless directed by your dietitian.
  • Do not have foods or drinks that may increase heartburn. Do not eat spicy foods. Do not have drinks that contain caffeine, such as coffee or colas. Do not drink alcohol.
  • Do not eat large meals. When you eat a lot of food at one time, your stomach needs more acid to digest it. Eat 6 small meals each day instead of 3 large ones, and eat slowly. Do not eat meals 2 to 3 hours before bedtime.
  • Elevate the head of your bed. Place 6-inch blocks under the head of your bed frame. You may also use more than one pillow under your head and shoulders while you sleep.

Prevent dumping syndrome:

Dumping syndrome happens when high-sugar or high-fat foods and drinks go into your intestine too quickly after a meal. Dumping syndrome may cause you to sweat, or feel faint, weak, and dizzy. It may cause you to feel full, have a fast heart rate, or have stomach cramps. Dumping syndrome may cause you to have an upset stomach and loose bowel movements. Your healthcare provider may tell you to do the following to prevent dumping syndrome:

  • Eat small meals throughout the day. Eat small meals to prevent food from moving too quickly into your intestine.
  • Limit carbohydrates in your meals. Your body turns carbohydrates into sugar. Too much sugar can cause dumping syndrome. Large amounts of carbohydrates are found in pasta, breads, and pastries. Read labels to find out how many grams of carbohydrates are in your food. Ask your healthcare provider how many carbohydrates you should eat in a meal.
  • Increase protein in your meals. Protein slows down your digestion. Foods that are high in protein include meat, fish, and beans. Read labels to find out how many grams of protein are in your food. Ask your healthcare provider how much protein you should eat in a meal.
  • Drink liquids between meals. Drink liquids before or after meals to help food move slower through into your intestine. Ask how much liquid to drink each day and which liquids are best for you.
  • Lie down for 30 minutes after you eat. Lie flat to help your body move food more slowly into your intestine. Do not lie down after a meal if you have reflux.

Do not smoke:

Nicotine can damage blood vessels and make it more difficult to heal from an esophagectomy. Smoking also increases your risk for cancer to return after treatment. You will need to remain a nonsmoker after surgery to prevent damage to your esophagus. Do not use e-cigarettes or smokeless tobacco in place of cigarettes or to help you quit. They still contain nicotine. Ask your healthcare provider for information if you currently smoke and need help to quit.

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Wound care:

Keep your incision and feeding tube site clean and dry. Change your dressings if they are wet or dirty. Check your incision and feeding tube site for signs of infection such as pus or swelling. Wash your incision and feeding tube site as directed by your healthcare provider.

Empty your drains as directed:

You may need to write down how much you empty from your drain.

Follow up with your healthcare provider as directed:

You may need more tests or more treatment. Write down your questions so you remember to ask them at your visits.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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