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Cancer » Esophageal Cancer

Esophageal Cancer and Surgery- All That You Must Know

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Your esophagus connects the throat and stomach. It's lined with two kinds of cells- squamous and gland. Both the cells can suffer from abnormal growth and thus cancer.

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Esophageal cancer is primarily treated with chemo and radiation therapy as surgery remains the last resort. However, the treatments sometimes involve a combination of all therapies in parts to achieve the maximum possible impact.

What's Esophagectomy?

The surgery for esophageal cancer, Esophagectomy, removes the cancer-affected part of the oesophagus as well as the stomach. In cases where a stomach part is removed, surgeons reconnect the oesophagus tube to the remaining stomach section. In cases where the entire oesophagus has to be disposed of, a section of the stomach is pulled up into the cavity and attached to the neck or chest to function as the new esophagus.

Techniques of Esophagectomy

Open esophagectomy procedure involves incisions in the abdomen, chest, or neck. It could be a transhiatal esophagectomy where the opening is sliced in the neck or abdomen. Or, it could be transthoracic esophagectomy where the incision is made in the abdomen and chest to remove the esophagus.

However, if the cancer is still in an early phase, surgeons prefer minimally invasive method. Several tiny incisions are made on the skin. A little telescopic tube is sent inside via a small cut to guide the surgery visually.  Other small incisions are used to put the instruments in and grab the affected part of oesophagus out.

Minimally invasive esophagectomy allows for quicker recovery and less traumatic post-op scars as compared to open esophagectomy. However, the former requires highly skilled surgeons.

Also, both kinds of oesophagal cancer surgery methods involve the removal of nearby lymph nodes. They are inspected for cancer cells to ensure how far the cancer has spread. Further treatment is planned after going through this prognosis.

Are There Any Risks in Esophagectomy?

Surgeries often involve simple risks like excess bleeding, clot formation, reaction to anaesthesia, infections in the wound, etc. Most of these are harmless and easily treatable with minimum hassle.

However, esophagectomy involves removing a particular and very natural part of your throat. Thus, lung complications, pneumonia, voice changes, narrowing of the food pipe, nerve reactions, and heartburn are pretty common post surgery.

One of the serious risks of this surgery is a misbehaving restructured oesophagus. The new junction connecting your stomach and oesophagus may develop a leak. If the stomach has been pulled into the chest area, its sac elasticity gets affected and may cause backing up of fluids and belly contents into the oesophagus.

Also, if the nerves guarding the stomach are affected by the surgery in any manner, it could lead to malfunctioning of the organ, for eg., too quick emptying of the sac. Often, minor surgeries are performed after the esophagectomy to deal with these complications.

It is easily possible for one of the seemingly harmless complications mentioned here to turn fatal. Thus, choosing an experienced surgeon and a reputed hospital is necessary while considering Esophagectomy.

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