Esophageal cancer is cancer of the esophagus, which is the tube that connects the mouth and stomach. The most common type of esophageal cancer surgery is an “esophagectomy,” which involves removing all or part of the esophagus.

A doctor may recommend an esophagectomy alone or in combination with other cancer treatments, such as chemotherapy or radiation therapy. Individual treatment plans will depend on cancer type and stage, as well as the person’s overall health.

This article discusses the purpose of esophageal cancer surgery and considers the risks involved. We also outline what to expect following the surgery and provide information on post-surgical outcomes.

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The primary goal of esophageal cancer surgery is to completely remove the tumor, thereby helping to prevent the cancer from spreading and minimizing the risk of it recurring.

The most common type of esophageal cancer surgery is an “esophagectomy,” which involves removing part or all of the esophagus. If a person receives an esophagectomy during the early stages of esophageal cancer, the surgery may cure the cancer.

Sometimes, a doctor may perform minor surgery to prevent swallowing difficulties and other symptoms of esophageal cancer. This type of surgery involves placing a feeding tube directly into the small intestine to encourage better nutrition.

An esophagectomy is a complex procedure that is associated with relatively high rates of recurrence and mortality. For this reason, a person’s eligibility for esophagectomy depends on several factors, including:

  • the person’s overall health
  • the location of the tumor
  • the extent to which the tumor has spread to other tissues or organs

A person can talk with their doctor or cancer care team about their eligibility for esophageal cancer surgery.

According to the American Cancer Society (ACS), there are two main types of esophagectomy — open and minimally invasive:

  • Open esophagectomy: This is the standard technique, during which the surgeon operates through one or more large cuts in the neck, chest, or abdomen.
  • Minimally invasive esophagectomy: Surgeons may recommend this technique for treating early stage esophageal cancer. During this procedure, the surgeon operates through a series of small incisions with the help of a device called a laparoscope. This is a thin, flexible, lighted tube that allows the surgeon to see inside the body while performing the surgery.

Both open esophagectomy and minimally invasive esophagectomy are complex surgeries that typically require a long hospital stay.

Other types of esophagectomy include:

  • Ivor Lewis technique
  • transhiatal esophagectomy
  • thoracoabdominal esophagectomy

Risks

As with other types of surgery, esophagectomy carries certain risks. These include:

An esophagectomy is a complex procedure that carries a high risk of potentially life threatening complications. For this reason, the ACS recommends that people considering an esophagectomy look for a surgeon who has plenty of experience in successfully carrying out the procedure. People should also ask the hospital for their survival statistics.

During an esophagectomy, a surgeon will remove the nearby lymph nodes. The medical term for this procedure is a “lymphadenectomy.”

After removing the lymph nodes, the surgeon will send them to a lab to check whether they contain any cancer cells. If cancer cells are present, a doctor may recommend additional cancer treatments, such as chemotherapy or radiation therapy.

Risks

The benefit of a lymphadenectomy is that it allows medical professionals to stage the cancer more accurately. Staging refers to the extent to which the cancer has spread beyond the site where it originated.

However, lymphadenectomy carries the following risks:

  • lymphedema, which is swelling of body parts due to a buildup of lymph fluid
  • postoperative infection
  • blood clots
  • nerve damage near the surgical site

Following esophagectomy, people typically remain in the hospital for 1–2 weeks for close monitoring. Typically, most people can return to their normal activities around 3 weeks after surgery.

According to the United Kingdom’s National Health Service (NHS), a person who has received an esophagectomy will typically remain in the hospital for around 10–14 days. The NHS adds that around 50% of people who receive this surgery develop a complication that increases the length of their hospital stay.

For the first 8 weeks following an esophagectomy, a person should avoid heavy lifting and other strenuous activities. According to the NHS, a full recovery may take several months.

Some people may go on to develop digestive issues following their surgery. During an esophagectomy, a surgeon reattaches the stomach to the remaining healthy portion of the esophagus. This changes the size and shape of the stomach and may result in rapid gastric emptying, or dumping syndrome (DS). Symptoms of DS typically occur shortly after a meal and may include:

A dietitian can work with a person to devise a meal plan that helps manage the symptoms of DS.

According to the ACS, removal of the esophagus and nearby lymph nodes can cure early stage esophageal cancer, which is cancer that has not spread beyond the esophagus. However, the ACS notes that doctors usually do not diagnose esophageal cancers early enough to cure them with surgery alone.

According to a 2022 review, people who undergo esophagectomy with or without additional cancer treatments have a 5-year relative survival rate of 30–45%. The outcome depends on the stage of the cancer, with early-stage cancers tending to have a better outlook than later-stage cancers.

The most common type of surgery for esophageal cancer is an esophagectomy, which involves the removal of all or part of the esophagus. During this procedure, surgeons will also remove nearby lymph nodes — called a lymphadenectomy — in an effort to stage the cancer. A lymphadenectomy also helps prevent the cancer from spreading or recurring.

Doctors may perform surgery as a stand-alone treatment or in combination with other cancer treatments, such as chemotherapy or radiation therapy. Individual treatment plans will depend on cancer type and stage, as well as the person’s overall health.

An esophagectomy is a complex procedure that carries risks. Anyone who is considering an esophagectomy should look for a surgeon who has extensive experience in carrying out the procedure successfully. A person can talk with their doctor or cancer care team for further advice.