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Surgery for Esophageal Cancer

Surgery for Esophageal Cancer

Surgery is the most common treatment for early stage esophageal cancer, especially cancer in the lower part of the esophagus. It is often combined with other treatments, such as radiation therapy and chemotherapy. It may be a good choice for you if either of these statements are true:

  • Your cancer is resectable (removable by surgery), and you are healthy enough to withstand anesthesia and the surgery itself.

  • Your symptoms could be relieved if the tumor were taken out, and you are healthy enough to withstand anesthesia and the surgery itself.

Just because you’re able to have surgery doesn’t mean that you have to choose this treatment. Before making a decision, think carefully about your lifestyle, the risks of having surgery and what to expect after it, other treatments available, and your quality of life. If you choose surgery, ask your doctor when you can expect to get back to your normal activities. You may also want to know what the scars will look like.

The type of surgery your doctor suggests for you and how much of your esophagus needs to be removed depend on the location of your cancer and how much it has spread. Make sure you talk with your doctor about what the goal of surgery is for you. In some cases, if the cancer is found early before it has spread from your esophagus, surgery can cure the cancer. In other cases, the doctor may suggest surgery to ease your symptoms, such as difficulty swallowing.

What happens during surgery

What happens during surgery depends on the type of surgery you are having. The type of surgery also affects where you have incisions. The surgeon may make an incision in your chest, your abdomen, or your neck. Sometimes, you may need more than one incision. You may be able to have the surgery using a laparoscope, which is a long, thin tool that helps your doctor see inside you. If you are able to have laparoscopic surgery, your incisions may be smaller.

These are the main types of surgery for esophageal cancer. For both types of surgery, you are first given anesthesia, a drug that makes you fall asleep and not feel pain:

  • Esophagectomy. For this surgery, the surgeon takes out part of the esophagus.

  • Esophagogastrectomy. For this surgery, the surgeon takes out part of the esophagus and part of the upper stomach.

Esophagectomy

This is the main type of surgery to treat cancer in the upper part of the esophagus. It is done for people who have early stage esophageal cancer that has not spread to the stomach. For this procedure, the surgeon removes the following:

  • The part of your esophagus that contains the cancer

  • Lymph nodes that are near your esophagus

If you have squamous cell cancer, the surgeon may need to remove a larger part of your esophagus because the cancer tends to start in the middle and upper parts of the esophagus.

After taking out part of your esophagus, the surgeon reconnects the parts that remain. Or your surgeon reconnects your esophagus to your stomach. Sometimes the surgeon must use part of your intestine to join the parts together.

The doctor sends the removed lymph nodes to a pathologist to see if they contain cancer. If they do, the cancer has spread.

Esophagogastrectomy

Your doctor will recommend this surgery if the cancer is at the lower end of your esophagus or has spread to your stomach. For this procedure, the surgeon removes the following:

  • The part of the esophagus with the cancer

  • The upper part of your stomach, next to your esophagus

  • Lymph nodes that are near your esophagus

The doctor sends the removed lymph nodes to a pathologist to see if they contain cancer. If they do, the cancer has spread.

With either type of surgery, in some cases, the tumor cannot be completely removed and it will continue to block the esophagus. In this situation, the surgeon may insert a metal tube called a stent inside your esophagus. The stent helps keep your esophagus open.

 
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