The esophagus (gullet) is the hollow muscular tube that carries food from the mouth down into the stomach. Esophageal cancer is a malignant cancer that affects the tissues lining the esophagus. It can occur in any part of the esophagus. Treatment for esophageal cancer aims at destroying these cancerous cells. Surgery is the most common treatment for esophageal cancer.
Esophageal cancer surgery aims at curing cancer by surgically removing the whole (total esophagectomy) or part of the esophagus (esophagectomy) and the surrounding tissue that is affected. The left-out esophagus is then reattached to the stomach after pulling it into the chest. When whole of esophagus is removed the whole stomach is pulled up in the chest and is used to replace esophagus. Sometimes a portion of the large intestine is cut and surgically attached to replace the esophagus. To reduce the risk of recurrence of cancer lymph nodes from the surrounding area are also removed (lymphadenectomy). In case the cancer spreads to the stomach, upper part of the stomach is removed along with part of affected esophagus (esophago-gastrectomy).
Surgery for esophageal cancer can be done by either an open approach or by a minimally invasive approach using laparoscopy (minimally invasive esophagectomy). But in certain cases it sometimes becomes necessary to switch from minimally invasive to open approach depending on the situation. The type of the approach depends on the situation and is decided by the surgeon.
In an open approach a large incision is made on the neck, chest or tummy depending on the location of the cancer and the required procedure is done. In laparoscopic approach the surgery is done in two parts. First the portion of the affected esophagus is removed laparoscopically through 3-4 small incisions in the chest. The surgeon can view the image on the monitor provided by the camera on the laparoscope inserted through one small hole in the chest during the surgery. The stomach is then reattached to the esophagus either through a large incision or by laparoscopy. Laparoscopic approach is less invasive and thus leads to less pain and fewer complications.
Some health funds will cover surgery for esophageal cancer. Please check with your health plans for details.
What are the risks and complications of surgery for esophagus cancer?
The major complications of the surgery may include pneumonia and leaking of digestive fluids at the place where the stomach is attached to the remaining esophagus. Surgery in severe cases of esophageal cancer is mostly done after chemotherapy and radiation therapy.