Bart Decadt

Consultant Laparoscopic Bariatric

& Upper GI Surgeon

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Oesphagectomy

How is the Oesophagectomy performed?

Oesophagectomy (removal of the oesophagus because of oesophageal cancer) can be performed by open surgery or keyhole or a combination of both. Mr Decadt performs usually a combination of both, laparoscopic (keyhole)  surgery to perform the abdominal part and open surgery to perform the thoracic part of the operation. This is to combine the benefits of keyhole with minimal post-operative pain and maximal view to remove the cancer and the glands around the cancer completely. Most of the oesophagus is removed and replaced by a tube made of a part of the stomach (the gastric conduit). All patients receive a feeding jejunostomy which is a small tube inserted in the intestine used to start feeding the patient the day after surgery while the anastomosis (joint) can heal safely without passage of food.

How long does the operation take?

As long as it takes. Usually between 5 and 8 hours. Duration is not really important. No other procedures are scheduled on the day of surgery. There is no pressure of time for the surgeon. The main issue is to have the tumour removed totally and safely.

How long will I stay in hospital after the surgery?

Usually around 10 to 14 days. Any complication may make the hospital stay longer.

Who is suitable for Oesophagectomy surgery?

About 1/3 of patients presenting with oesophageal cancer are suitable for surgery. Suitability for surgery depends of the size of the tumour and if the tumour has spread or not. This is assessed during multiple tests which are discussed in a weekly occurring MDT (multi disciplinary team) meeting between surgeons, oncologists, radiologists, pathologists, cancer nurse specialists and other cancer specialists together.

What are the benefits of Oesophagectomy surgery?

The aim of oesophagectomy is to remove the tumour safely and completely in order to provide cure.

What are the risks of Oesophagectomy surgery?

Oesophagectomy is a major undertaking and one of the biggest operations in intestinal surgery. Complications do happen in about 30% of procedures and there is an about 5% mortality risk. Complications can include bleeding, infection, pain, obstruction, anastomotic leak and gastric tube complications. All respiratory, cardiac and general surgery complications can occur. All aspects of surgery and all other aspects of the disease can be discussed with the surgeon and/or specialist nurse in the surgical clinic during the multiple clinics.

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POST-OPERATIVE Care