Expert Esophagus Tumor Surgery

If you have cancer in your esophagus (esophageal cancer), you may need an en bloc esophagectomy. This surgery permanently removes your esophagus, the tube connecting your throat to your stomach. Your surgeon will also remove the tumor and nearby lymph node tissue to stop the cancer from spreading. Lymph nodes are glands in your immune system that filter fluids. After the removal, your surgeon will reconstruct your digestive system with your small intestine, stomach and remaining esophagus so you can continue eating.

You can count on our esophageal specialists to give you a well-informed prognosis for the tumor in your esophagus. We offer the latest esophagus tumor surgery and treatment options, so you have a better outcome.

How to Prepare for Your En Bloc Esophagectomy

En bloc esophagectomy is a major surgery that requires preparation. Your doctor will run several tests to ensure you’re ready for the procedure. Your prep may include:

• Imaging tests to locate the tumor for removal
• Management of existing conditions like diabetes and high blood pressure to avoid complications
• Meetings with a dietitian and speech-language pathologist to prepare for changes after surgery
• Other cancer treatments like chemotherapy and radiation therapy
• Plans for hospital and at-home recovery

You also may need to follow a liquid diet and avoid certain medications before surgery. Your doctor will give you specific instructions to prepare for your procedure.

What Happens During an En Bloc Esophagectomy?

En bloc esophagectomies can last three to six hours. Before your procedure, you’ll receive anesthesia, so you fall asleep and do not feel pain. You may also have an epidural catheter (tube) placed under the skin in your back to deliver pain medication after surgery.

During the procedure, your surgeon will make an incision in your neck, chest and abdomen to reach your esophagus. After the surgeon removes the diseased tissue, they will pull your stomach and small intestine up into your chest area and connect it to your remaining esophagus. They may also remove lymph nodes around your esophagus to test for cancer.

Your surgeon will place a feeding tube into your stomach or small intestine. This tube will help you receive nutrients while you regain your ability to swallow. Your surgeon will also insert a nasogastric tube through your nose to empty excess air from your stomach. You may have tubes in your chest to drain fluid as well.

What Happens After an En Bloc Esophagectomy?

After surgery, you won’t be able to swallow. You’ll spend a day or two in the intensive care unit (ICU) to recover. Your care team will give you nutrition through your feeding tube and use your epidural to manage pain. After a few days, you’ll take liquid pain medications through your feeding tube. When ready, your provider will remove your nasogastric tube and drains.

You’ll spend up to two weeks in the hospital during recovery. Our esophageal specialists will help you continue your care at home. We’ll teach you how to clean your feeding tube and incision. You’ll also receive breathing exercises to help open your lungs.

You’ll continue using your feeding tube for a couple of months. Once your provider removes it, you can start with a liquid diet and soft foods. Your doctor will tell you when it’s safe to resume your regular diet. Since your digestive system will be shorter, food digestion may take longer. You may need to eat several small meals throughout the day rather than three large ones. Be sure to cut your food into small pieces and chew slowly as you adjust.

Everyone’s condition is different. It may take a year or two to fully heal and adapt after surgery. Your care team will be by your side at every step. We’ll give you the support, resources and expertise you need to return to your everyday life.