Oesophagectomy refers to removal of part or the entire oesophagus (food pipe, or gullet) and replacement with another organ (usually the stomach). This is most commonly performed for Oesophageal Tumours but rarely may also be performed for benign oesophageal diseases with severe symptoms, which do not respond to other treatments.
Removal of the oesophagus is a very large operation. This is due to the fact the oesophagus is deep in the body surrounded by many major organs and that is travels from the neck, through the chest to the upper abdomen. The surgery is performed in 2 or 3 stages with incisions in the abdomen, chest and sometimes in the neck.
The most common reason for oesophagectomy is for cancer. In this setting, all the surrounding fatty tissue and lymph nodes are removed along with the oesophagus and the tumour in an attempt to remove all the cancer cells from the body. Depending on the stage or extent of the cancer chemotherapy and/or radiotherapy may also be required.
After the appropriate section of the oesophagus has been removed, then the gap is bridged by another organ, (usually the stomach). The important part of this reconstruction is the anastomosis (join), made high in the chest or in the neck between the remaining stomach and the remaining top part of the gullet.
In some circumstances it may be possible to perform part of the operation by Keyhole Surgery. The size of the incisions is markedly reduced with the use of keyhole surgery and in doing so the amount of postoperative pain and pain related complications can also be reduced.
Recovery after oesophagectomy is at least one to two weeks in hospital, but can be many more days or even weeks.