Esophagectomy is a procedure that involves removal of the esophagus and replacement of the esophagus by the stomach, the colon (large intestine) or, in selected cases, the small bowel. When the stomach is used to replace the esophagus, the procedure is called “esophagectomy and gastric pull-up.”When the colon is used to replace the esophagus, the procedure is called “esophagectomy and colon interposition.” When the small bowel is used to replace the esophagus the procedure is called “esophagectomy and jejunal interposition.”
The procedure is performed for the treatment of:
- Malignant diseases of the esophagus: Esophageal cancer
- End-stage benign (non-cancerous) diseases of the esophagus:
- End-stage achalasia
- End-stage gastroesophageal reflux disease, Barrett’s esophagus with high-grade dysplasia, or in patients following multiple redo antireflux surgery.
- Intractable peptic ulcer (not responsive to medical treatment)
Patients stay in the hospital for seven to 10 days, on average. They will be on a soft diet for about eight weeks following discharge from the hospital, and then gradually return to their regular eating habits.
Different types of esophagectomy are performed, based on the location and depth of the tumor (how deep the tumor has penetrated into the wall of the esophagus) if performed for esophageal cancer, and on the patient’s overall state of health and the surgeon’s preference.
The graphic below shows the different types of esophagectomy.
Schematic Presentation of Different Types of Esophagectomy