Why is this procedure done?
The esophagus is a tube that food passes through to get from the mouth to the stomach. Surgery to take out all or part of this tube is an esophagectomy. You may need this surgery if your food pipe is damaged because of an injury, disease, or tumor. ‚
Your doctor may take out all or part of your esophagus. The doctor may replace it with part of your stomach or intestine. ‚
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What will the results be?
The doctor will remove the damaged part of your esophagus. Your signs may disappear. ‚
What happens before the procedure?
- Your doctor will take your history. Talk to your doctor about:
- All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
- Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin, ibuprofen, Aleve (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about them.
- When you need to stop eating or drinking before your procedure.
- Your doctor will do an exam and may order:
- Lab tests
- X-rays
- Ultrasound
- You will not be allowed to drive right away after the procedure. Ask a family member or a friend to drive you home.
What happens during the procedure?
- Once you are in the operating room, the staff will put an IV in your arm to give you fluids and drugs. You will be given a drug to make you sleepy. It will also help you stay pain free during the surgery.
- There are different ways the doctor may do this procedure. How the doctor will do this depends on how big the damage on your esophagus is. The doctor may:
- Make a cut on your neck and belly
- Only make a cut on your belly
- Make one long cut from the chest down to your belly
- Do the surgery using a few small cuts and tools with a camera. This is a minimally-invasive procedure.
- Your doctor will clean your skin with an antiseptic. Based on the method used, the doctor will make a cut on your skin. Your doctor will find the damaged part of the esophagus. Your doctor will cut the damaged part and take it out of your body.
- If possible, your doctor will connect the stomach and the rest of the esophagus. Otherwise, your doctor may need to use part of your bowel to make a new esophagus.
- Sometimes, lymph nodes are taken out for testing.
- Your doctor may put a tube into your belly before closing the cuts. This tube will help you get nutrition until you are able to eat again.
- Your doctor will close your cut with stitches or staples and cover it with clean bandages.
- The procedure takes 5 to 10 hours.
What happens after the procedure?
- You will go to the Recovery Room for monitoring and the staff will watch you closely. You may have to stay in the hospital for 7 to 10 days.
- Your doctor may leave a tube in your nose or in your belly. Keep this tube in place.
- You will be sore when the anesthesia wears off. Your doctor will give you drugs for pain.
- You may have a tube in your bladder. This will help your doctor monitor how much you pass urine.
What care is needed at home?
- Ask your doctor what you need to do when you go home. Make sure you ask questions if you do not understand what the doctor says. This way you will know what you need to do.
- Your doctor will give you drugs for pain and to prevent infection. Ask your doctor or pharmacist how to take your drugs.
- You may go home with a tube in your nose or belly. You may have this tube for 1 to 2 months. This tube will take food and drugs directly to your stomach. Your doctor will tell you how to take care of this tube.
- Talk to your doctor about how to care for your cut site. Ask your doctor about:
- When you should change your bandages
- When you may take a bath or shower
- If you need to be careful with lifting things over 10 pounds
- When you may go back to your normal activities like work or driving
- Be sure to wash your hands before touching your wound or dressing.
- It will be painful to swallow for a few of days. Suck on ice chips to help ease throat pain.
- Do not eat anything by mouth until your doctor says it is OK. Your doctor will tell you when you can eat.
- Most often you will start with soft foods like soups and pureed fruits and vegetables. You can start eating solid foods when your doctor says so.
- Your doctor may tell you to use a saline mouth rinse. Use this after every meal or when needed.
- Try to sit when eating. This will help prevent acid reflux.
- Your doctor will tell you to wear compressive stockings to prevent blood clots. Try to get out of bed and walk around a day after your surgery.
What follow-up care is needed?
- Your doctor may ask you to make visits to the office to check on your progress. Be sure to keep these visits.
- The doctor may schedule you for a special x-ray procedure 5 to 7 days after the surgery. This will help show how your esophagus is healing and if you are ready for soft foods.
- If you have stitches or staples, you will need to have them taken out. Your doctor will often want to do this in 1 to 2 weeks.
- Your doctor may send you to a dietitian. The dietitian may give you a specific diet for your feeding tube. The dietitian will tell you what foods you can and cannot eat.
What lifestyle changes are needed?
- Eat small meals 5 to 6 times a day rather than 3 big meals. Eat your last meal of the day at least 3 hours before you go to bed.
- Drink 6 to 8 glasses of water each day.
- Chew your foods well before swallowing.
- Avoid foods that can cause heartburn. Some of these foods include:
- Milk
- Chocolate
- Cream soups and sauces
- Gravies
- Citrus fruits
- Spicy foods
- Ice cream
- Stay away from foods that can cause gas and bloating. Some of these foods are:
- Beans
- Cabbage
- Onions
- Apples
- Avocados
- Cantaloupe
- Nuts
- Avoid using straws, drinking carbonated drinks, and chewing gum. These will make you swallow air and can cause bloating.
What problems could happen?
- Sinus, throat, and ear pain from the nasogastric tube
- Belly cramps, upset stomach, and loose stools
- Infection
- Bleeding
- Feeding tubes might fall out
- A part of the bowel might bulge out of the wound. This is a hernia.
When do I need to call the doctor?
- Signs of infection. These include a fever of 100.4 ‚ °F (38 ‚ °C) or higher, chills, very bad sore throat, pain with passing urine, wound that will not heal.
- Signs of wound infection. These include swelling, redness, warmth around the wound; too much pain when touched; yellowish, greenish, or bloody discharge; foul smell coming from the cut site; cut site opens up.
- Feeding tube comes out
- Throat pain not relieved by drugs
- Throwing up with or without blood
- Problems keeping any food or liquids down
- Problems with burping or throwing up
- Chest pain
- Sudden breathing problems
- Swallowing problems
- Voice hoarseness
- You are not feeling better in 2 to 3 days or you are feeling worse
Consumer Information Use and Disclaimer
This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚
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Copyright ‚ © 2015 Clinical Drug Information, LLC and Lexi-Comp, Inc. ‚