Esophagectomy

About Esophagectomy

Esophagectomy is the removal of part or most of the esophagus, the muscular tube that carries food from the throat to the stomach. It is most often performed for esophageal cancer, usually after chemotherapy or chemoradiotherapy, and occasionally for severe benign conditions such as end stage achalasia or damage from swallowing caustic substances. After the diseased portion is removed, continuity is usually restored by pulling the stomach up into the chest or neck and shaping it into a tube, a so called gastric conduit, although colon or small bowel can be used instead. Common techniques include the Ivor Lewis approach through the abdomen and right chest, the transhiatal approach through the abdomen and neck, and the three incision McKeown approach. Minimally invasive and robotic versions combine laparoscopy and thoracoscopy. Esophagectomy is regarded as one of the more complex operations in general and thoracic surgery, and outcomes tend to be better at high volume specialist centers. Eating patterns change afterward because the stomach is repositioned.