Esophagogastrectomy

What is Esophagogastrectomy

Esophagogastrectomy is a procedure to remove part of the tube that carries food and liquid from your throat to your stomach (esophagus). The upper part of your stomach and some lymph nodes may also be removed.

Many times, your stomach will then be attached directly to the part of your esophagus that remains.

This procedure may be done if you have cancer or if it is thought that you may develop cancer. This procedure may also be done if you have a severe injury to your esophagus or dysfunction of your esophagus.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines.
• Damage to other structures or organs.
• Breathing problems.
• Swallowing problems.
• Fluid collection in the lungs.

What happens before the procedure?

• Follow instructions from your health care provider about eating or drinking restrictions.
• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood.Do nottake these medicines before your procedure if your health care provider instructs you not to.
• Plan to have someone take you home after the procedure.
• If you go home right after the procedure, plan to have someone with you for 24 hours.
• Do notuse tobacco products, including cigarettes, chewing tobacco, or e-cigarettes. If you need help quitting, ask your health care provider.
• Ask your health care provider how your surgical site will be marked or identified.
• You may be given antibiotic medicine to help prevent infection.

What happens during the procedure?

• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
• An IV tube will be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to make you fall asleep (general anesthetic).
• You may have a flexible tube (catheter) put into your bladder to drain urine.
• You may have a tube put through your nose or mouth into your stomach (NG tube). This removes digestive fluids and prevents you from vomiting and feeling nauseous.
• Your surgeon will make incisions. They may be made in the throat, chest, or abdomen.
• Any affected part of the stomach will be stapled off. Then, it will be removed.
• The affected part of your esophagus will be removed.
• Any affected lymph nodes will be removed.
• The remaining part of the stomach will be attached to the remaining part of the esophagus.
• The incisions will be closed with stitches (sutures).
• Bandages (dressings) will be placed over the incisions.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.
• You will be given medicine for pain as needed.
• Do notdrive for 24 hours if you received a sedative.
• The head of your bed will be kept at an upright angle.
• You may have an NG tube that goes through your nose and into your stomach.
• You may have a feeding tube. This tube will give you the proper nutrition until you can eat food with your mouth.
• You may have tubes draining fluid from the incisions.
• You will have a catheter in your bladder.
• You may have to wear compression stockings. These stockings help to prevent blood clots and reduce swelling in your legs.
• You will be taught breathing exercises. These help your lungs recover from the anesthesia.

Esophagogastrectomy, Care After

Refer to this sheet in the next few weeks. These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After the procedure, it is common to have:

• Pain or soreness.
• Difficulty swallowing.
• Looser and more frequent bowel movements.
• Heartburn.

Follow these instructions at home:

Incision care

• Follow instructions from your health care provider about how to take care of your incision. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do notremove adhesive strips completely unless your health care provider tells you to do that.
• Check your incisions every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.

Activity

• Do nothave sex until your health care provider approves.
• Do notlift anything that is heavier than 10 lb (4.5 kg).
• Rest as told by your health care provider. Ask your health care provider when you can resume your usual activities, including work.
• Do notdrive for 24 hours if you received a sedative.
• Do notdrive or operate heavy machinery while taking prescription pain medicine.
• Do breathing exercises as told by your health care provider.

General instructions

• Follow your health care provider’s instructions on caring for your feeding tube, if you have one. A home health nurse may come to your home to help you. A feeding tube may stay in place for several weeks. It can be removed when you are able to eat.
• Follow instructions from your health care provider about eating or drinking restrictions.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• Wear compression stockings as told by your health care provider. These help to prevent blood clots and reduce swelling in your legs.
• Do nottake baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you can take showers. You may only be allowed to take sponge baths.
• Do notuse tobacco products, including cigarettes, chewing tobacco, or e-cigarettes. If you need help quitting, ask your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• Your pain is not controlled with medicine.
• You have trouble swallowing.
• You have heartburn or indigestion.
• You feel nauseous or you vomit.
• You cannot have a bowel movement (constipated) or have diarrhea.
• You have a new cough or hoarseness.
• You cough or choke while eating or drinking.
• You have more redness, swelling, or pain around your incision.
• You have more fluid or blood coming from your incision.
• Your incision feels warm to the touch.
• You have pus or a bad smell coming from your incision.
• You have a fever or chills.

Get help right away if:

• Your dressing becomes soaked with blood.
• Your pain becomes severe.
• You have pain, tenderness, or redness in your calf.
• You are unable to swallow.
• You have chest pain.
• You have difficulty breathing.