Esophagectomy is the surgical removal of the lower two-thirds or nearly the entirety of the esophagus, along with the uppermost part of the stomach, and all of the surrounding lymph nodes. The stomach is then reshaped into a "new esophagus," brought up into the chest or the neck, and reconnected to the remaining portion of the esophagus (Figures 1-6).
The operation is technically challenging and can result in high mortality and morbidity if performed by less experienced surgeons who perform only a few esophagectomies per year. The thoracic surgeons at Stanford perform between 40 and 60 esophagectomies per year with exceptional outcomes. We perform all of the various, available esophagectomy techniques at Stanford, depending upon patient factors and the particular tumor's location, stage, and extensiveness:
- Ivor Lewis Esophagectomy: the esophageal tumor is removed through an abdominal incision and a right thoracotomy (a surgical incision of the chest wall). The esophagogastric anastomosis (reconnection between the stomach and remaining esophagus) is located in the upper chest.
- Transhiatal Esophagectomy: the esophageal tumor is removed through abdominal incision, without thoracotomy, and a left neck incision. The esophagogastric anastomosis is located in the neck. This procedure may also be considered "minimally invasive" as compared with #1 and #3.
- "Three Incision Esophagectomy": the esophageal tumor is removed through an abdominal incision, right thoracotomy, and left neck incision. The esophagogastric anastomosis is located in the neck.
- Minimally Invasive Esophagectomy: the esophageal tumor is removed through small abdominal incisions and small incisions in the right chest (thoracoscopy). The esophagogastric anastomosis is located in the upper chest as in the "open" Ivor Lewis technique (#1, above). Read more about Minimally Invasive Esophagectomy in the next tab.
The nursing staff on the thoracic surgical wards at Stanford is experienced and very knowledgeable in the postoperative care of patients who undergo esophagectomy, further enhancing patient recovery.
The broad experience and highly specialized training of Stanford's thoracic surgeons allows them to offer comprehensive and high quality surgical care for patients with esophageal cancer. We have achieved outstanding surgical outcomes for esophageal cancer, making us a center of excellence for the treatment of this disease.