ESOPHAGECTOMY - open
Open esophagectomy is surgery to remove part or all of the esophagus. This is 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 or a severely damaged stomach. During open esophagectomy, one or more large surgical cuts (incisions) are made in your belly, chest, or neck. (Another way to remove the esophagus is laparoscopically.
This article discusses three types of open surgery. With any surgery, you will receive medicine (anesthesia) that will keep you asleep and pain-free.
• The surgeon makes two large cuts. One cut is in your neck area and one is in your upper belly.
• From the cut in the belly, the surgeon frees the stomach and lower part of the esophagus from the nearby tissues. From the cut in the neck, the rest of the esophagus is freed.
• The surgeon then removes the part of your esophagus where the cancer or other problem is.
• Your stomach is then reshaped into a tube to make a new esophagus. It is joined to the remaining part of your esophagus with staples or stitches.
• During surgery, lymph nodes in your neck and belly are likely removed if cancer has spread to them.
• A feeding tube is placed in your small intestine so that you can be fed while you are recovering from surgery.
• Drainage tubes may be left in the chest to remove fluid.
This surgery is done in a similar way as the transhiatal procedure. But the upper cut is made in your right chest, not in the neck.
En bloc esophagectomy:
• The surgeon makes large cuts in your neck, chest, and belly. All of your esophagus and part of your stomach are removed.
• The rest of your stomach is reshaped into a tube and placed in your chest to replace your esophagus. The stomach tube is connected to the remaining esophagus in the neck.
• The surgeon also removes all lymph nodes in your chest, neck, and belly.
Most of these operations take 3 to 6 hours.
Surgery to remove the lower esophagus may also be done to treat:
• A condition in which the ring of muscle in the esophagus does not work well (achalasia)
• Severe damage of the lining of the esophagus that can lead to cancer (Barrett esophagus)
• Severe trauma
• Destroyed esophagus
• Severely damaged stomach