MBBS (AIIMS), MS (Surgery, AIIMS), MNAMS, FACS (USA), FICS (USA), FUICC
Fri, 15 Dec 2023
The esophagus is a salient part of the digestive system that connects your oral cavity to your stomach. Also called the food pipe, the esophagus is the organ that delivers the food from your mouth to the stomach when you swallow. Any damage or disease associated with the esophagus calls for surgery where all or a part of this tube is removed. This procedure is called esophagectomy in medical terms.
An esophagectomy can be performed in different ways and to address several conditions. Several diagnostic procedures are required before you undergo this surgery to ensure your eligibility and the procedures safety. Similarly, some major lifestyle and habit changes are essential to recover from the procedure efficiently.
Dr. Arvind Kumar is a renowned chest surgeon and provides the best care in even the most complex surgeries like an esophagectomy.
We suggest an esophagus surgery to treat a disease or relieve the symptoms of a condition. The most common conditions that require an esophagectomy include:
This is the most common reason for an esophagectomy. If a cancerous growth is detected in any part of the esophagus early on, removing that part may prevent the disease from spreading. Usually, a part of the nearby lymph nodes is also taken for testing. If cancerous cells are found in the gland sample, there is a chance that the cancer has metastasized to other organs.
The esophagus has a thin pink inner lining. Barrett’s esophagus is a condition where this inner lining becomes red and inflamed. This could be the result of frequent acid reflux or other factors. The exact cause of Barrett’s esophagus is not yet known. People with this condition often experience pain and difficulty while swallowing and have a persistently dry throat and dry cough. This is the second most common condition that calls for an esophagus surgery.
GERD is a condition associated with acid reflux and is characterized by symptoms like sore throat, hoarseness, difficulty in swallowing, persistent sensation of a lump in your throat, and recurring chest pain. It often damages the inner lining of the esophagus and surgery is required to manage the condition.
Benign conditions like a non-cancerous growth in or around the esophagus, narrow esophageal tube, esophageal ulcer, and others may require an esophagectomy. Here, the extent and severity of the procedure depend on the condition and the degree of damage to the esophagus.
An esophagectomy is performed in different ways, based on the condition to be addressed, the location of the tumor or damage, and whether a small or large part needs to be removed. Primarily, these methods can be divided into minimally invasive procedures and open surgeries.
These methods involve making small and usually a few incisions to perform the surgery. For this, our surgeon performs any of the following procedures:
These are major surgeries that involve long incisions. We generally suggest this method if there is significant damage to the esophagus. Usually, our surgeon removes the damaged part of the esophagus and connects the healthy part to the abdominal opening. Therefore, you’ll have a shorter food pipe but will be able to eat normally.
We follow different approaches to an esophagectomy procedure. This generally depends on the location of the surgical site and the type and number of incisions to be made.
This technique involves making incisions in the neck region. Here, a part of the esophagus is removed. The stomach is fashioned into a cylindrical form and pulled up into the neck area to be attached to the lower part of the remaining esophagus. This method is apt for both benign and malignant conditions.
This method is usually chosen when the gastroesophageal junction is to be operated. This is the part where the esophagus meets the stomach. Ivor Lewis esophagectomy is usually performed to treat esophageal cancer in the lower region of the esophagus. Here, our surgeon makes an incision in the abdomen and another on the right side of the chest wall, a method called right thoracotomy.
The method is also called tri-incision esophagectomy, meaning it involves making incisions in three different regions. This procedure is preferred when the higher region of the esophagus is to be operated. The three incisions used here include an abdominal incision (laparotomy), an incision on the right side of the chest wall (right thoracotomy), and one on the left side of the throat.
This procedure involves two incisions—one long one on the left side from the chest to the abdomen and the other in the neck area. The incisions allow the doctor better access to the gastroesophageal junction and other parts of the esophagus for more efficient operation.
Before an esophagectomy, we always ensure that you are eligible for the procedure and that your body can successfully endure and heal from the surgery. We also perform some pre-surgical tests to get a better idea of the target location and scope of the operation.
Here’s what you can expect before an esophagus surgery.
We run a thorough health checkup to determine your health status and monitor your sugar levels, blood pressure, and other parameters. If you have conditions like hypertension, diabetes, or others, our first aim is to regulate them before the surgery to prevent them from hindering your recovery.
You may need to follow a new diet and take certain medications or supplements. Also, quitting tobacco and nicotine is crucial in this step as they slow down your healing process.
You would undergo one or more imaging tests to locate the tumor or the damaged tissues in the esophagus. This helps our doctors to plan the appropriate approach to the surgery. The common imaging tests performed before an esophagectomy include a CT scan of the chest and abdominal area, an endoscopic ultrasound, a PET scan, an endoscopy, and a barium swallow test.
Our doctor may suggest that you undergo some preliminary treatment to manage or reduce the severity of the condition before the surgery. For conditions like Barrett’s esophagus and GERD, it may involve taking some anti-inflammatory drugs along with other medications and therapy. For cancer patients, this could include undergoing other cancer treatments like chemotherapy and radiotherapy. This helps in shrinking or limiting the tumor to a specific area and makes its removal much easier.
Around two to three weeks before the surgery, you might be required to make certain changes in your diet and medications. For instance, our doctor would readjust or stop your dosage of medications like blood thinners that may interfere with the surgical or healing process. A few hours before the surgery, you would need to fast and switch from a solid to a liquid diet.
You would need to prepare for other factors like hospital stay and your recovery at home later on. Consult with our doctor beforehand about the precautions and instructions for a smooth recovery. Make the necessary arrangements, like deciding on a proper diet after the surgery, so it is easier for you during recovery.
Our doctors would administer general anesthesia before the esophagectomy procedure. So you would be unconscious during the surgery and would not feel any pain. The incisions are made according to the location of the tumor or the damaged tissues of the esophagus.
For non-cancerous conditions, our surgeon removes the damaged tissues or removes the damaged part of the esophagus and connects the remaining ends. In the case of esophageal cancer, they would obtain a sample of the lymph nodes around the affected area for testing. If these samples test positive for the presence of cancerous cells, the cancer has likely traveled to other parts of the body through the lymphatic system.
The duration of the surgery may range from three to six hours, although it depends on the complexity of the procedure. After the esophageal surgery, you would be required to stay in the hospital for a few days to weeks.
We would preferably keep you under close medical surveillance after an esophagectomy for around one to two weeks. You would likely have epidural catheters to prevent pain from the surgical wounds and a nasogastric tube to flush out the air and fluids from the chest cavity. Instead of eating normally, you may be given nutrients through an IV or a feeding tube for a few days following the surgery.
It usually takes over a month to recover from an esophagectomy. During your stay at home after returning from the hospital, you’ll need to maintain a proper diet, take the prescribed medications religiously, and follow up with your doctor to check your healing status.
With over 40 years of experience in the medical field, Dr. Arvind Kumar is a renowned name in the healthcare sector. He is highly skilled in both traditional and modern methods of chest and thoracic surgeries. His expertise is backed by numerous acknowledgments, awards, and, most importantly, the long list of happy patients who received satisfactory treatment and care at his hands.
Dr. Arvind Kumar provides top-quality care at highly affordable prices. His medical team ensures that all your concerns and doubts are addressed and answered and that you are comfortable throughout the procedure.
To get the best-quality esophagus surgery from a highly experienced and adept surgeon, book a consultation now with Dr. Arvind Kumar.
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License Number: U.P State Medical Council (India) No. 27637