Esophagectomy
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Esophagectomy
An esophagectomy is a surgical procedure to remove part or all of the oesophagus, which is the tube that connects the throat to the stomach. It is often used to treat esophageal cancer or conditions that cause severe damage such as GERD. During the procedure, the surgeon may also remove nearby lymph nodes to reduce the risk of cancer spread. The remaining part of the oesophagus is usually reconnected to the stomach to maintain the digestive tract’s function.
Types of Esophagectomy Techniques
Esophagectomies involve removing part or all of the oesophagus to treat conditions like cancer or severe damage. The surgical approach depends on the tumour’s location and the most suitable technique for each patient. Surgeons may perform an open surgery, which involves a larger incision, or opt for a minimally invasive approach, which uses smaller incisions and advanced tools to access the oesophagus. Several specific techniques are used depending on the surgical access needed:
- Transhiatal Esophagectomy: Involves incisions in both the neck and abdomen. This approach avoids opening the chest and is often used when the tumour is located in the lower oesophagus.
- Ivor Lewis Esophagectomy: Includes an incision on the right side of the chest and another in the abdomen, commonly used for cancers in the middle to lower oesophagus.
- The McKeown Esophagectomy: Involves three incisions—one each in the neck, chest, and abdomen—providing broad access to address more extensive cancer spread.
- Thoracoabdominal Esophagectomy: Involves a single, longer incision from the chest to the abdomen on the left side. It may also include a neck incision for upper esophageal cancers or complex cases requiring extensive resection.
Risks of Esophagectomy
Esophagectomy is a significant surgery, and while it can be an effective treatment for certain conditions, it does carry some risks. Understanding these potential complications can help patients make informed decisions and know what to expect during recovery.
- Infection
- Bleeding or blood clots
- Anastomotic leak (when the reconnected parts of the oesophagus and stomach don’t fully heal)
- Difficulty swallowing
- Pneumonia, given the oesophagus’s proximity to the lungs
- Reflux
- Weight loss
- Voice changes
How is an Esophagectomy Performed
The surgical approach can vary depending on the patient’s condition and the surgeon’s preferred technique, which may be open or minimally invasive. Here’s a step-by-step overview of how an esophagectomy is typically carried out:
The patient is placed under general anaesthesia to ensure they are comfortable and pain-free throughout the surgery.
Depending on the chosen technique, the surgeon makes incisions in the neck, chest, abdomen, or a combination of these areas.
The affected portion of the oesophagus, along with any nearby lymph nodes if needed, is carefully removed.
To restore the digestive tract, the stomach or another section of the intestine is reshaped and connected to the remaining part of the oesophagus.
Once the new pathway is secured, the surgeon closes the incisions with stitches or staples.
After the surgery, the patient is monitored in recovery for any immediate complications and begins the initial stages of healing.
Recovery After Esophagectomy
Recovery from an esophagectomy typically involves a hospital stay of around 7–10 days. The initial focus is on monitoring vital signs, managing pain, and preventing complications. Patients may have a temporary feeding tube to support nutrition until they can swallow comfortably. Full recovery can take 3-6 months as the body adjusts to the changes.
Eating & Drinking
Patients may begin by drinking small amounts of liquids before slowly moving to soft foods. Eating smaller, frequent meals is generally recommended to avoid discomfort and help with digestion. Patients should avoid lying down soon after eating to reduce the risk of acid reflux.
Speaking
In some cases, patients may experience temporary hoarseness or changes in their voice due to the proximity of surgery to the vocal cords and nerves. This usually improves as recovery progresses, but speech therapy can help if needed.
Hygiene
Keeping surgical sites clean is essential for healing. Patients should follow their surgeon’s instructions on wound care, such as gently washing the area and avoiding baths until the incisions heal fully. Showering is generally allowed, but incisions must be kept dry.
Exercise
Light activity, such as walking, is encouraged soon after surgery to promote circulation and prevent blood clots. Strenuous activities or heavy lifting should be avoided until cleared by the surgeon. Gradually increasing activity levels can aid in a smoother recovery.
Esophagectomy Cost in Singapore
The recommended surgeon’s fee for an esophagectomy in Singapore ranges from $20,492 – $28,885 at private hospitals. This cost covers the surgeon’s expertise but excludes additional hospital and consumable fees, which can vary based on the facility and specific requirements of the procedure.
Expert Cardiothoracic Surgeons Experienced in Esophagectomy
At O2 Lung Centre, our team comprises specialised cardiothoracic surgeons with deep expertise and advanced training to deliver comprehensive and personalised care for patients undergoing esophagectomy and other thoracic procedures.
With significant experience in managing complex esophageal conditions, our surgeons approach each case with precision and a patient-centred focus, guiding you through every stage of your treatment journey.
For more information and personalised treatment options, please WhatsApp our clinic at Gleneagles Hospital or Mount Elizabeth Orchard Hospital.