What is an esophagectomy?

An esophagectomy (say "ee-sof-uh-JEK-tuh-mee") is surgery to remove all or part of the esophagus. The esophagus is the tube that carries food from the throat to the stomach. Nearby lymph nodes and other tissue may also be removed. The doctor connects the remaining healthy part of the esophagus to the stomach so that you can still swallow and eat food. This surgery is mainly used to treat esophageal cancer. But it can also be used for other problems with the esophagus.

During the surgery, the doctor makes large cuts in the belly and the upper chest or neck. These cuts are called incisions. Where they are depends on where the problem is. After surgery, you may be in the hospital for 1 to 2 weeks.

You have to be very careful about what you eat for 1 to 2 months after surgery and maybe for the rest of your life. You may have a feeding tube (J-tube) in your belly when you go home. This is to be sure you get enough nutrition. This will come out when you are able to eat normally. How long this takes varies. For many people, it takes 4 to 6 weeks after surgery. Your doctor will give you detailed information on your diet and how to use the J-tube.

You may feel weak after surgery. Take good care of yourself. Get enough rest and stay active. This can help you heal faster. You will probably need to take at least 6 to 12 weeks off from work. This depends on the type of work you do and how you feel. You will need more time to get better if you need other treatment for cancer, such as chemotherapy.

Having cancer can be scary. You may feel many emotions and may need some help coping. Seek out family, friends, and counsellors for support. You also can do things at home to help you feel better while you go through treatment. Your doctor can guide you to many local resources for support and more information. Call the Canadian Cancer Society (1-888-939-3333) or visit its website at www.cancer.ca for more information.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

What happens before surgery?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• Tell your doctors ALL the medicines and natural health products you take. Some of these can increase the risk of bleeding or interact with anesthesia.
• If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if you should stop taking these medicines before your surgery. Make sure that you understand exactly what your doctor wants you to do.
• Your doctor will tell you which medicines to take or stop before your surgery. You may need to stop taking certain medicines a week or more before surgery. So talk to your doctor as soon as you can.
• If you have an advance care plan, let your doctor know. Bring a copy to the hospital. If you don't have one, you may want to prepare one. It lets your doctor and loved ones know your health care wishes. Doctors advise that everyone prepare these papers before any type of surgery or procedure.

What happens on the day of surgery?

• Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be cancelled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
• Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
• Do not shave the surgical site yourself.
• Take off all jewellery and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery centre

• Bring a picture ID.
• The area for surgery is often marked to make sure there are no errors.
• You will be kept comfortable and safe by your anesthesia provider. You will be asleep during the surgery.
• The surgery will take 3 to 8 hours.

Going home

• Be sure you have someone to drive you home. Anesthesia and pain medicine make it unsafe for you to drive.
• You will be given more specific instructions about recovering from your surgery. They will cover things like diet, wound care, follow-up care, driving, and getting back to your normal routine.

When should you call your doctor?

• You have questions or concerns.
• You don't understand how to prepare for your surgery.
• You become ill before the surgery (such as fever, flu, or a cold).
• You need to reschedule or have changed your mind about having the surgery.