The Center for Thoracic Oncology at the Boston Medical Center is dedicated to the diagnosis and treatment of tumors of the esophagus and chest. We take a multidisciplinary approach to your care, offering you the most effective treatments, including esophagectomy. At the Center for Thoracic Oncology, we know that a cancer diagnosis creates uncertainty for you and your family. That's why in addition to our medical expertise, we provide compassionate care that focuses on giving you the best experience possible.
Esophageal cancer is the uncontrolled growth of abnormal cells in the esophagus, which is a flexible tube connecting the throat to the stomach. Approximately between 10 and 13 inches long, the esophagus contracts when you swallow, to push food down into the stomach. Mucus helps move this process along.
Esophagectomy is the surgical removal of the esophagus. Esophagectomy typically is recommended when the cancer has not spread to other parts of your body, and is potentially curable.
In esophagectomy, most of your esophagus and nearby lymph nodes are removed. Your stomach is then moved up and attached to the remaining portion of your esophagus. There are several techniques for performing esophagectomy. Your surgeon will consider several factors such as your overall condition, the size and location of the tumor, and the involvement of the tissue and organs near the tumor.
Common approaches to esophagectomy are:
How to Prepare
Prior to your surgery, you will meet with your surgeon. At that time, your surgeon will review the results of all tests and diagnostic procedures that have been done up to that point, ask you about your medical history, and perform a physical examination. The surgeon will discuss his or her findings and recommendations.
Please tell your doctor if you have any allergies to medication or have had problems with anesthesia. Your surgeon will give you any specific instructions about dietary or activity restrictions, and he or she will instruct you about whether you should take your regular medications on the day of the procedure. You will also be asked to not eat or drink after midnight on the night before your procedure.
What to Expect
In some cases, you will be admitted to the hospital the day before your surgery. This is so antibiotics can be given and so bowel preparation can be completed. Bowel preparation involves drinking a solution that will empty your bowel before the surgery. Esophagectomy is performed under general anesthesia and is a complex, time-consuming procedure. What happens once the procedure begins depends on the approach your surgeon takes:
Whichever approach is used, your physician will leave a small feeding tube that can be used to provide nutrition while your esophagus heals. This is not a permanent tube, and removing it is not difficult or painful.
Depending on the approach your surgeon takes, esophagectomy takes approximately 5 to 10 hours to complete.
Following your surgery, you will be transferred to the Post Anesthesia Unit. This is a recovery area near the operating room where you will be connected to several monitoring devices. Members of the team will watch your condition closely as you awaken from anesthesia. When you have recovered sufficiently, you will be transferred to a bed in the intensive care unit. Nurses in these units are specialists in caring for patients who have had esophageal surgery.
Before you go home, your physician or nurse will teach you how to care for your incision. Gradually, over the course of a few weeks, you will regain your strength and be able to return to work and participate in physical activity. Be sure to call your doctor if you notice any of the following:
Always take your medicine exactly as prescribed. Call us if you have any questions or changes.