Esophagectomy for Cancer

Steven C. Immerman, M.D., FACS © 2001

About esophageal cancer
The esophagus is the swallowing tube that goes from the throat to the stomach. When it becomes involved with cancer the most common symptom is difficulty swallowing. Occasionally the tumor can bleed as well. Surgical removal of the esophagus along with the tumor is the best treatment for this type of cancer. It is the only type of treatment that gives a chance at curing the cancer, and it usually will improve the difficulty with swallowing.

About the operation
The operation can take anywhere from three to five hours, and is commonly done in one of two ways:

• through the belly and right side of the chest  or
• through the belly and left side of the neck

The approach that is used depends upon the size and location of the tumor. Sometimes, the decision regarding which approach to take is made during the operation, after the incision on the belly is made and the abdomen is explored. With either operation almost all of the esophagus is usually removed, and the stomach is brought up into the chest or neck to replace the esophagus and allow swallowing postoperatively.

What to expect after surgery
After the esophagus has been removed and replaced with the stomach, patients find that eating is a different experience that it was before the operation. Hopefully, swallowing will be much improved if the tumor was blocking the esophagus. However, eating and swallowing will not be exactly "normal", but is often quite satisfactory. Each person notices differences related to their particular operation. The more common symptoms are:

• slow swallowing
• getting full quickly
• diarrhea
• poor appetite
• irritation of the remaining esophagus

Many of these symptoms can be helped with medications. The goal of the operation is to get patients back to eating solid food, and eating enough to maintain or increase their weight, and the operation is usually successful in achieving this.