Esophageal resection





Definition

An esophageal resection is the surgical removal of the esophagus, nearby lymph nodes, and sometimes a portion of the stomach. The esophagus is a hollow muscular tube that passes through the chest from the mouth to the stomach—a "foodpipe" that carries food and liquids to the stomach for digestion and nutrition. Removal of the esophagus requires reconnecting the remaining part of the esophagus to the stomach to allow swallowing and the continuing passage of food. Part of the stomach or intestine may be used to make this connection. Several surgical techniques and approaches (ways to enter the body) are used, depending on how much or which part of the esophagus needs to be removed; whether or not part of the stomach will be removed; the patient's overall condition; and the surgeon's preference.

There are two basic esophageal resection surgeries. Esophagectomy is the surgical removal of the esophagus or a cancerous (malignant) portion of the esophagus and nearby lymph nodes. Esophagogastrectomy is the surgical removal of the lower esophagus and the upper part of the stomach that connects to the esophagus, performed when cancer has been found in both organs. Lymph nodes in the surrounding area are also removed.

An esophageal resection may be performed in combination with pre- and postoperative radiation and chemotherapy (chemoradiation).


Purpose

An esophagectomy is most often performed to treat early-stage cancer of the esophagus before the cancer has spread (metastasized) to the stomach or other organs. Esophagectomy is also a treatment for esophageal dysplasia (Barrett's esophagus), which is a precancerous condition of the cells in the lining of the esophagus. Lymph nodes are removed to be tested for the presence of cancer cells, which helps to determine if the cancer is spreading. Esophagectomy is also recommended when irreversible damage has occurred as a result of traumatic injury to the esophagus; swallowing of caustic (celldamaging) agents; chronic inflammation; and complex motility (muscle movement) disorders that interfere with the passage of food to the stomach.

An esophagogastrectomy is performed when cancer of the esophagus has been shown to be spreading to nearby lymph nodes and to the stomach, creating new tumors. When cancer invades other tissues in this way, it is said to be metastatic. The goal of esophagogastrectomy is to relieve difficult or painful swallowing (dysphagia) in patients with advanced esophageal cancer, and to prevent or slow the spread of metastases to more distant organs such as the liver or the brain.


Demographics

The candidates for esophageal resection parallel those at high risk for esophageal cancer. Esophageal cancer is found among middle-aged and older adults, with the average age at diagnosis between 55 and 60. Esophageal cancer and esophageal dysplasia occur far more often in men than in women. One type of esophageal cancer (squamous cell carcinoma) occurs more frequently in African Americans; another type (adenocarcinoma) is more common in Caucasian males. Caucasian and Hispanic men with a history of gastroesophageal reflux disease (GERD) are also at increased risk, because GERD has been shown to cause changes in the cells of the esophagus that may lead to cancer. Higher risks are also associated with smoking (45%), alcohol abuse (20%), and lung disorders (23%).


Description

Esophageal cancer is diagnosed in about 13,000 people annually in the United States; it is responsible for approximately 1.5–5% of cancer deaths each year. Although it is not as prevalent as breast and colon cancer, its rate of occurrence is increasing. This rise is thought to be related to an increase in gastroesophageal reflux disease, or GERD.

The esophagus has a muscular opening, or sphincter, at the entrance to the stomach, which usually keeps acid from passing upward. In people with GERD, the esophageal sphincter allows partially digested food and excess stomach acid to flow back into the esophagus. This occurrence is known as regurgitation. Regurgitation continually exposes the lining of the esophagus to large amounts of acid, causing repetitive damage to the cells of the esophageal lining. The result is Barrett's esophagus, a condition in which the normal cells (squamous cells) of the esophageal lining are replaced by the glandular type of cells that normally line the stomach. Glandular cells are more resistant to acid damage but at the same time, they can more readily develop into cancer cells. Studies at New York's Memorial Sloan-Kettering Hospital have shown that only 30% of people diagnosed with Barrett's esophagus will later be diagnosed with cancer; the other 70% will not develop dysplasia, the precancerous condition. Effective medical treatment of acid reflux is thought to be a factor in the low incidence of cancer in people with Barrett's esophagus. Other types of cancer can also occur in the esophagus, including melanoma, sarcoma, and lymphoma.

The risk factors for esophageal cancer include:

  • Use of tobacco. The highest risk for esophageal cancer is the combination of smoking and heavy alcohol use.
  • Abuse of alcohol.
  • Barrett's esophagus as a result of long-term acid reflux disease.
  • A low-fiber diet; that is, a diet that is low in fruits and vegetables, and whole grains that retain their outer bran layer. Other dietary risk factors include such vitamin and mineral deficiencies, as low levels of zinc and riboflavin.
  • Accidental swallowing of cleaning liquids or other caustic substances in childhood.
  • Achalasia. Achalasia is an impaired functioning of the sphincter muscle between the esophagus and the stomach.
  • Esophageal webs. These are bands of abnormal tissue in the esophagus that make it difficult to swallow.
  • A rare inherited disease called tylosis, in which excess layers of skin grow on the hands and the soles of the feet. People with this condition are almost certain to develop esophageal cancer.

Cancer of the esophagus begins in the inner layers of the tissue that lines the passageway and grows outward. Cancer of the top layer of the esophageal lining is called squamous cell carcinoma; it can occur anywhere along the esophagus, but appears most often in the middle and upper portions. It can spread extensively within the esophagus, requiring the surgical removal of large parts of the esophagus. Adenocarcinoma is the type of cancer that develops in the lower end of the esophagus near the stomach. Both types of cancer may develop in people with Barrett's esophagus. Prior to 1985, squamous cell carcinoma was the most common type of esophageal cancer, but adenocarcinoma of the esophagus and the upper part of the stomach is increasing more rapidly than any other type of cancer in the United States. Up to 83% of patients undergoing esophagectomy have been shown to have adenocarcinoma. This development may be related to such changes in risk factors as decreased smoking and alcohol use as well as increased reflux disease. People at high risk for esophageal cancer should be examined and tested regularly for changes in cell types.

Esophageal cancer is classified in six stages determined by laboratory examination of tissue cells from the esophagus, nearby lymph nodes, and stomach. The six stages are:

  • Stage 0. This is the earliest stage of esophageal cancer, in which cancer cells are present only in the innermost lining of the esophagus.
  • Stage I. The cancer has spread to deeper layers of cells but has not spread into nearby lymph nodes or organs.
  • Stage IIA. The cancer has invaded the muscular layer of the esophageal walls, sometimes as far as the outer wall.
  • Stage IIB. The cancer has invaded the lymph nodes near the esophagus and has probably spread into deeper layers of tissue.
  • Stage III. Cancer is present in the tissues or lymph nodes near the esophagus, especially in the trachea (windpipe) or stomach.
  • Stage IV. The cancer has spread to more distant organs, such as the liver or brain.

Unfortunately, the symptoms of esophageal cancer usually don't appear until the disease has progressed beyond the early stages and is already metastatic. Without early diagnostic screening, patients may wait to consult a doctor only when there is little opportunity for cure. The symptoms of esophageal cancer may include difficulty swallowing or painful swallowing; unexplained weight loss; hiccups; pressure or burning in the chest; hoarseness; lung disorders; or pneumonia.

The decision to perform an esophageal resection will be made when staging tests have confirmed the presence of cancer and its stage. Two-thirds of people who undergo endoscopy, a close examination of the inside lining of the esophagus, and biopsies (testing esophageal tissue cells) will already have cancer, which can progress rapidly. Some will be treated with surgery and others with medical therapy, depending on the stage of the cancer, the patient's general health status, and the degree of risk. Removing the esophagus or the affected portion is the most common treatment for esophageal cancer; it can cure the disease if the cancer is in the early stages and the patient is healthy enough to undergo the stressful surgery. Esophagectomy will be recommended if early-stage cancer or a precancerous condition has been confirmed through extensive diagnostic testing and staging. Esophagectomy is not an option if the cancer has already spread to the stomach. In this case an esophagogastrectomy will usually be performed to remove the cancerous part of the esophagus and the upper part of the stomach.


Esophagectomy

An esophagectomy takes about 6 hours to perform. The patient will be given general anesthesia, keeping him or her unconscious and free of pain during surgery. One of several approaches or incisional strategies will be used, chosen by the surgeon to gain adequate access to the upper abdomen and remove the esophagus or the tumor and the nearby lymph nodes. The four common incisional approaches are: transthoracic, which involves a chest incision; Ivor-Lewis, a side entry through the fifth rib; three-hole esophagectomy, which uses small incisions in the chest and abdomen to accommodate the use of instruments; and transhiatal, which involves a mid-abdominal incision. The approach chosen depends on the extent of the cancer, the location of the tumor or obstruction, and the overall condition of the patient.

In a minimum-access laparoscopic and thorascopic procedure, the surgeon makes several small incisions on the chest and abdomen through which he or she can insert thin telescopic instruments with light sources. The abdomen will be inflated with gas to enlarge the abdominal cavity and give the surgeon a better view of the procedure. First, the camera-tipped laparoscope will be inserted through one small incision, allowing images of the organs in the abdominal area to be displayed on a video monitor in the operating room . If the surgeon is going to use a portion of the stomach to replace the resected esophagus, he or she will first locate the fundus, or upper portion of the stomach. The fundus will be manipulated, stapled off, and removed laparoscopically, to be sutured in place (gastroplasty) as a replacement esophagus.

Next, the surgeon will pass thorascopic instruments into the chest through another incision. The esophagus or cancerous portion of the esophagus will be visualized, manipulated, cut and removed. Lymph nodes in the area will also be removed. Then the surgeon will either pull up a portion of the stomach and connect it to the remaining portion of the esophagus (anastomosis), or use a piece of the stomach or intestine, usually the colon, to reconstruct the esophagus. Either procedure will allow the patient to swallow and pass food and liquid to the stomach after recovery. As discussed above, other approaches may be used to gain access to the affected portion of the esophagus.

There are several variations of an esophagectomy, including:

  • Standard open esophagectomy. This technique requires larger incisions to be made in the chest ( thoracotomy ) and in the abdomen so that the surgeon can dissect the esophagus or cancerous portion and remove it along with the nearby lymph nodes. The esophagus can then be reconnected to the stomach using a portion of either the stomach or the colon.
  • Laparoscopic esophagectomy. This is a less invasive technique performed through several small incisions on the chest and abdomen with the camera-tipped laparoscope and a video monitor to guide removal of the esophagus or tumor along with nearby lymph glands.
  • Vagal-sparing esophagectomy. This procedure preserves the branches of the vagus nerve that supply the stomach, with only minimal alteration of the size of the stomach and the nerves that control acid production and digestive functions.

Esophagogastrectomy

An esophagogastrectomy is also major surgery performed with the patient under general anesthesia. The surgeon will choose the incisional approach that allows the best possible access for resecting the lower portion of the esophagus and the upper portion of the stomach. The surgeon's decision will depend on the extent of the cancer, the amount of the esophagus that must be removed, and the patient's overall health status. An esophagogastrectomy can be performed as an open procedure through large incisions, or as a laparoscopic procedure through small incisions.

In a minimum-access laparoscopic procedure, several small incisions are made in the patient's abdomen. A laparoscope will be inserted through one small incision, allowing images of the abdominal organs to be displayed on a video monitor. As in an esophagectomy, gas may be used to inflate the abdominal cavity for better viewing and space for the surgeon to maneuver. The cancerous upper portion of the stomach will first be stapled off and resected. The cancerous portion of the esophagus will then be cut and removed along with nearby lymph nodes. Finally, a portion of the stomach will be pulled upward and connected to the remaining portion of the esophagus (anastomosis); or, if most of the esophagus has been removed, a piece of the colon will be used to construct a new esophagus. Sometimes the surgeon must make an incision in the neck in order to gain access to and resect the upper portion of the esophagus, followed by making an anastomosis between the esophagus and a portion of the stomach.


Diagnosis/Preparation

Diagnosis

The diagnosis of esophageal cancer begins with a careful history and a review of symptoms, and involves a number of different diagnostic examinations. An esophagoscopy may be performed in the doctor's office, allowing the doctor to examine the inside of the esophagus with a lighted telescopic tube (esophagoscope). A barium swallow is another common screening test, performed in the radiology (x ray) department of the hospital or in a private radiology office. In a barium swallow, the patient drinks a small amount of radiopaque (visible on xray) barium that will highlight any raised areas on the wall of the esophagus when chest x-rays are taken. The xray studies will reveal irregular patches that may be early cancer or larger irregular areas that may narrow the esophagus and could represent a more advanced stage of cancer. If either of these conditions is present, the doctors will want to confirm the diagnosis of esophageal cancer; determine how far it has invaded the walls of the esophagus; and whether it has spread to nearby lymph nodes or organs. This staging process is essential in order to determine the best treatment for the patient.

One staging technique is a diagnostic procedure called endoscopic ultrasound. The doctor will thread an endoscope, which is a tiny lighted tube with a small ultrasound probe at its tip, into the patient's mouth and down into the esophagus. This procedure allows the inside of the esophagus to be viewed on a monitor to show how far a tumor has invaded the walls of the esophagus. At the same time, the doctor can perform biopsies of esophageal tissue by cutting and removing small pieces for microscopic examination of the cells for cancer staging. Staging tests may also include computed tomography ( CT scans ); thorascopic and laparoscopic examinations of the chest and abdomen; and positron emission tomography (PET) .

Preparation

The patient will be admitted to the hospital on the day of the operation or the day before, and will be taken to a pre-operative nursing unit. The surgeon and anesthesiologist will visit the patient to describe the resection procedure and answer any questions that the patient may have. The standard preoperative blood and urine tests will be performed. Intravenous lines (IV) will be inserted in the patient's vein for the administration of fluids and pain medications during and after the surgery. Sedatives may be given before the patient is taken to the operating room.


Aftercare

Immediately after surgery the patient will be taken to a recovery area where the pulse, body temperature, and heart, lung, and kidney function will be monitored. Several hours later, the patient will be transferred to a concentrated care area. Surgical wound dressings will be kept clean and dry. Pain medication will be given as needed. A chest tube inserted during surgery will be checked for drainage and removed when the drainage stops. A nasogastric (nose to stomach) tube, also placed during surgery, will be used to drain stomach secretions. Nurses will check it regularly and rinse it out. It will eventually be removed by the surgeon. Until the patient is able to swallow soft foods, he or she will be fed intravenously or through a feeding tube that was placed in the small intestine during surgery. Patients will be encouraged to cough and to breathe deeply after surgery to fully expand the lungs and help prevent infection and collapse of the lungs. Walking and movement will also be encouraged to promote a quicker recovery.

About 10–14 days after the surgery, the patient will be given another barium swallow so that the doctor can examine the esophagus for any areas of leaking fluid. If none are seen, the nasogastric tube can be removed. The patient can then begin to sip clear liquids, followed gradually by small amounts of soft foods. Patients being treated for esophageal cancer may begin chemotherapy (cytotoxic or cell-killing medications), radiation therapy, or both, before or soon after discharge from the hospital . Patients typically remain in the hospital as long as two weeks after surgery if no complications have occurred.

When the patient goes home, any remaining bandages must be kept clean and dry. Frequent walking and gentle exercise are encouraged. Because laparoscopic and thorascopic surgery is less invasive and uses only small incisions, there is less trauma to the body, and activity can be resumed more quickly than with open procedures that require larger incisions. The patient should report any fever or chills, persistent pain, or incision drainage to the surgeon. The patient's diet will typically be restricted for a while to soft foods and small portions; a normal diet can be resumed in about a month, but with smaller quantities. Patients are advised not to drive if they are still taking prescribed narcotic pain medications. Daily care and assistance at home is recommended during the recuperation period. Regular medical care and periodic diagnostic testing, such as endoscopic ultrasound, is essential to monitor the condition of the esophagus and to detect recurrence of the cancer or the development of new tumors.


Risks

One of the primary risks associated with esophageal resection surgeries is leakage at the site of the anastomosis, where a new feeding tube was sutured (stitched) to the remaining esophagus. As many as 9% of all patients have been reported to develop leaks, most occurring when a portion of the stomach rather than the colon was used to construct the new section of the esophagus.

Other risks include:

  • formation of blood clots that can travel to the heart, lungs, or brain
  • nerve injury, which can cause defective emptying of the stomach
  • infection
  • breathing difficulties and pneumonia
  • adverse reactions to anesthesia
  • narrowing of the remaining esophagus (strictures), which may cause swallowing problems
  • increased acid reflux and heartburn as a result of injury to or removal of the esophageal sphincter

Normal results

Esophageal resection, especially esophagectomy, can be curative if cancer has not spread beyond the esophagus. About 75% of patients undergoing esophagectomy will be found to have metastatic disease that has already spread to other organs. Esophagectomy will reduce symptoms in most patients, especially swallowing difficulties, which will improve the patient's nutritional status as well. Patients whose esophagectomy is preceded and followed by a combination of chemotherapy and radiation treatments have longer periods of survival.

The typical result of an esophagogastrectomy is palliation, which is the relief of symptoms without a cure. Because esophagogastrecomy is always performed when metastases have already been found elsewhere in the body, the procedure may relieve pain and difficulty in swallowing, and may delay the spread of the cancer to the liver and brain. Cure of the disease, however, is not an expectation.

Patients having less invasive laparoscopic and thorascopic resection procedures will experience less pain and fewer complications than patients undergoing open procedures.


Morbidity and mortality rates

Because 75% of all esophagectomy patients and 100% of all esophagogastrectomy patients will have metastatic disease, morbidity and mortality rates for these procedures are high. Thirty-day mortality for esophagectomy ranges from 6–12%; it is 10% or higher for esophagogastrectomy. Survival of early-stage cancer patients after esophagectomy ranges from 17 to 34 months if surgery alone is the treatment. The mortality rate for early-stage cancer patients having esophagectomy alone is higher than when surgery is combined with pre- and post-operative chemoradiation. The three-year survival rate for early-stage cancer patients who received pre- and post-esophagectomy chemoradiation is about 63%. Better staging techniques, more careful selection of patients, and improved surgical techniques are also believed to be responsible for the increase in postoperative survival rates. Recurrence of cancer in esophagectomy patients has been shown to be about 43%. A higher percentage of patients undergoing esophageal resections survive beyond the 30-day postoperative period in hospitals where the surgeons perform these procedures on a regular basis.


Alternatives

People with Barrett's esophagus can be treated with medicine and dietary changes to reduce acid reflux disease. These nonsurgical approaches are effective in relieving heartburn, calming inflamed tissues, and preventing further cell changes.

Fundoplication, or anti-reflux surgery, can strengthen the barrier to acid regurgitation when the lower esophageal sphincter does not work properly, curing GERD and reducing the exposure of the esophagus to excessive amounts of acid.

Photodynamic therapy (PDT) is the injection of a cytotoxic (cell killing) drug in conjunction with laser treatments, delivering benefits comparable to more established treatments. Endoscopic laser treatments that deliver short, powerful laser beams to the tumor through an endoscope can improve swallowing difficulties; however, multiple treatments are required and the benefits are neither long-lasting nor shown to prevent cancer.

Resources

BOOKS

American Cancer Society. The American Cancer Society's Complementary and Alternative Cancer Methods Handbook . Atlanta, GA: American Cancer Society, 2002.

Harpham, Wendy S., MD. Diagnosis Cancer: Your Guide Through the First Few Months . New York: W. W. Norton, Inc., 1998.

Heitmiller, R. F., et al. "Esophagus," in Martin D. Abeloff, ed., Clinical Oncology , 2nd ed. New York: Churchill Livingstone, 2000.


ORGANIZATIONS

American Cancer Society. 1599 Clifton Road NE, Atlanta, GA 30329. (800)ACS-2345. http://www.cancer.org .

American Gastroenterological Association. 4930 Del Ray Avenue, Bethesda, MD 20814. (301) 654-2055. http://www.gastro.org .

OTHER

Ferguson, Mark, MD. Esophageal Cancer . Society of Thoracic Surgeons. http://www.sts.org/doc4121 .

National Cancer Institute (NCI). General Information About Esophageal Cancer . Bethesda, MD: NCI, 2003.


L. Lee Culvert

WHO PERFORMS THE PROCEDURE AND WHERE IS IT PERFORMED?


Esophageal resection surgeries are performed in a hospital or medical center operating room by a general surgeon or a thoracic surgeon.

QUESTIONS TO ASK THE DOCTOR


  • Why do I need this surgery?
  • How will the surgery be performed? How long will it take?
  • How many times have you performed this procedure? How often is it performed in this hospital?
  • How much discomfort can I expect in the short term? Over the long term?
  • Will this surgery cure my cancer? Will it allow me to live longer?
  • What are the chances that the cancer will come back?
  • What are my options if I don't have the surgery?
  • What are the risks involved in having this surgery?
  • What kind of care will I need at home afterward?
  • How quickly will I recover?


User Contributions:

carla
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May 21, 2009 @ 7:19 pm
Hi, my name is carla. My mother is going to have this done on 6-17-09 She doesn't have cancer. She had a dilation last aug. and the dr. rupture her esophus. she hasn't ate since. what is her servival rate? they have aleady took her rib out and used the muscal to seal the hole.
Roezee
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Jun 24, 2009 @ 12:00 am
I am scheduled for the gastoesophageal surgery because I have a tumor in the fundus of the stomach which begins at the esophugus. I have been told that the lesion is not malignant but due to where it lies in the stomach, it should be removed. Can anyone tell me if they think it should come out or if it is ok for the benign tumor to remain?
Maryann
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Aug 21, 2009 @ 2:14 pm
Helpful - precise, informative - difficult surgery
Newell
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Aug 29, 2009 @ 6:18 pm
My father had his esophagus removed due to cancer in early July. The surgery went well, but he is having a very difficult time with recovery. Very difficult. Doctors say he just needs to eat, but no one seems to understand the challenges. He's also producing a viscus, frothy liquid that he has to cough up out of his throat. It's very difficult for him and no one can explain. There doesn't seem to be any restriction of the new "esophagus." But the nausea and challenges of eating anything persist. I've resorted to looking under the post-operative symptoms of gastric bypass surgery, because they seem relevant given that he's had most of his stomach taken to recreate the esophagus. Can anyone share their experiences?
roezee
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Aug 30, 2009 @ 12:00 am
Hi
I had my sugery on 7/29/09 and the g.i.s.t was removed from my stomach. The miracle is that the esophagus was not touched as the g.i.s.t was much bigger than was anticipated and it came out all in one piece. The upper part of my stomach was taken out (making the surgery a partial gastrectomy). I have lost 30 lbs in 4 weeks and I am unable to each more than a 1/4 sandwich at a time. Meat, candy, soda, chips actually junk is a turn off. I can't even think of eating it. I am greatful. I am still tired, my incision is leaking serosangunous fluid but this too shall pass. I am not ready to return to work as Ineed more time to heal. I hope my experience helps all. God and prayer works. bigtime.
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Mar 3, 2010 @ 1:13 pm
Hi,

I had the bottom 1/3 of my esophagus removed along with a non-cancerous tumor a year and a half ago and am still having major complications. I now have incredible pain at the surgery site and the upper part of my esophagus and I have incredible bouts of throwing up for days. If anyone has had this type of surgery can you please contact me at:

thatguyjedi@hotmail.com

I would love to discuss my issues with someone who understands and who has gone through this. Thank you.

-Paul
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Jul 8, 2010 @ 9:09 am
I had my esophagus removed on 12/2/2002. I have had some problems but I am still kicking. I have a Doctor that his group has started a survivors support group. We meet one day every month. Being in a group we teach each other things we have gone through and sugest things that help. If anyone has any questions. Email me. If I can I will answer any thing I can.
Rich
Please put {Esophageal cancer} in subject box
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Aug 11, 2010 @ 6:06 am
A friend had his esophagus removed years ago due to cancer. For 2 years now he has a bad cough(where even breathing is restricted) the doctors say is reflux. Has anyone had this symptom and did they find a solution.
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Sep 3, 2010 @ 6:18 pm
had this operation a couple years ago. Main problem since then is can't eat most foods, and subsist on Ensure and baby foods. If I eat the wrong thing, my system shuts down my swallowing for minutes to hours. My gall blader drives me crazy. Other than that, I'm alive. Given what I know now, I might have tried alternative cures first.
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Sep 24, 2010 @ 4:16 pm
Hi i had esophagus cancer and had the operation in january 2008, all went ok and was not to bad after surgary, but then i have started have really bad burning in my troat, i am waiting for another enscopey, which is due on the 5th oct, but have been told to stop all my medicine for 2 weeks, its really unbareable the acid, i can take gaviscon but that all. does any one else have this trouble after surgary.
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Nov 26, 2010 @ 5:17 pm
I think this was a great article as I face esophagus surgery in the next few weeks. I know what to expect before hand. My cancer is in the lower 1/3 portion and not in any other organs or lymph glands. My biggest concern is that I also have have COPD and difficult breathing issues. I want the cancer removed before it has a chance to spread to other areas. I am a 70 year old male.
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Dec 25, 2010 @ 10:10 am
iam a 38 yr.old male and had an esophagectomy in aug. i am home and have since had problems of the same nature. i had my gall bladder removed also in the past three wks. i just got out of the hospital again and still have no relief. have you found anything that helps i have nausea and nothing i eat goes down right. have you found anything that helps?
Hope hegedus
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Mar 4, 2011 @ 4:04 am
A friend of mines husband is having his esophagus removed due to stage 2 throat cancer. What is the quality of life after the operation?
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Mar 4, 2011 @ 10:10 am
My 38yr. old husband was diagnosed with esophegeal cancer Sept.2010. He completed 6 weeks of chemo therapy along with daily radiation treatments. In Jan. 2011 he had a transhiatal esphajectomy. The surgery was a huge success he had almost no complications at all, other than blood loss during surgery. He seemed to be recovering exceptionally well, however now after about 8 weeks he has started to have trouble getting food and drink to travel down the "new" esophagus completely. Almost all instances result in vomitting because the contents wont go down. Sometimes this makes it very difficult for him to breathe making matters worse because then he begins to panic. We have contacted the surgeon for some answers with no avail other than scheduling an appt. Has anyoneever had this same experience? We are looking for some help in eliminating this problem ASAP!
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Mar 10, 2011 @ 8:08 am
I am a 53 year old white female who underwent surgery to repair a hiatus hernia. Somewhere along the line my oesophagus was damaged and I ended up with a sleeve gastrectomy and I now have oesophageal stenosis. The ability to swallow 'normal'diet has almost disappearred and my specialist now informs me I have developed 'maladaptive eating behaviours'to cope. I have dilatations every three months and the next step is apparently the 'full monty'oesophagectomy. Having read the previous posts I am now more inclined to stay away from further surgical intervention. My biggest gripe is that the surgeons are not willing to listen, to take responsibility and provide little if anything in terms of aftercare. I am aneamic, my iron stores are all subclinical from the crappy food that I CAN eat and no one can agree on when it would be a good idea for me to have a transfusion. Advice to eat soft, eat slow, eat low residue is all well and good - how to do it in reality is the million dollar question.
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Mar 15, 2011 @ 10:22 pm
Carla, my mom is having the same thing done tomorrow. And it was fro. The same reason. Can you give me any more info about what happened to your mom?
ANON
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Mar 23, 2011 @ 7:19 pm
My husband was diagnosed last July with esophageal cancer after having been treated for "an ulcer" for months. He had the Ivor-Lewis surgery in August 2010 followed by ten weeks of chemo and radiation and has still not recovered. He is on a feeding tube (Glucerna-during the night)and does not eat. He can sip some water or juice and has tried some broth but for all intents and purposes he is not eating. He has lost 86 pounds in a year and he is extremely weak. He has the "frothy liquid" back-up that Newell previously described and sometimes he goes into a fit of coughing. He has pulling and stretching inside the abdomen and is in pain most of the time. Tomorrow they will do an endoscopy to see if the "new" esophagus is blocked in some way. They were going to wait until May but I insisted they do something now. I feel as though there is not enough information given regarding post-surgery problems. No one seems to know what the "pulling,stretching and frothy liquid" are. The doctors shake their head and show sympathy but they do not give out concrete information. Thanks for all your comments-at least we are not alone.
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May 10, 2011 @ 12:12 pm
I am a nurse and one of my patients has esophageal cancer. Has been thru radiation and chemotherapy. Removal of the lower part of esophagus and upper part of stomach is now recommended. To make an informed decision, I would like to know the "after-effects" of thsi surgery and what things can you NOT do. She has been told she will have to sleep upright the rest of her life. Can she bend over to do her garden work? Will she develop more reflux from stomach contents not being held down any more? Will she be more prone to coughing, reflux burning, food riding up the remaidner of the esophagus? any help would be welcomed. She's tryign to decide: should I go thru with the surgery or should I just take my chnaces given the high percentage of recurrence. Will look forward to whatever advice you can give me. Thank you.
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May 29, 2011 @ 8:20 pm
I had esophagogastrectomy surgery on 1-6-11 its now 5-28-11, was diagnosed with stage III cancer of the esophagus in april of 2010. Went thru chemo. and radiation treatment prior to my surgery in october thru november...it was rough...i went from 230 lbs to 165 lbs while going thru the chemo radiation part.
nancy
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Jul 15, 2011 @ 12:12 pm
Hi I am a 64 year old female who was born with a high acid content which damaged my esophagus and burned it shut. I had my first surgery when I was 5. The Drs. cut out the narrow part and pulled my stomach up and reconnected my esophagus. Went 3x weekly for dialation. 15 years later I went in for the colon replacement. I did well until 10 years ago I started having pneumonia on a regular basis. Due to reflux and not having a sphincter muscle. I was told at that time if I didn't have surgery with in 10 years my lungs would be gone. I had the surgery the Drs cut out 10 inch of colon due to your colon stretching. I do sleep with my bed up and don't eat anything after 6 pm.I still have the reflex and cough a lot sometimes up to 3 hrs or more which keeps me up at night. I a
PuffyHon
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Sep 6, 2011 @ 11:11 am
ANON,

My husband was diagnosed with Stomach Cancer (top of the stomach growing into the lower portion of the esophagus). He underwent surgery on Aug. 4th, removing 20% of his lower esophagus-removing the plug "spinter" and removing 20% of his upper portion of his stomach). He was doing quite well at the hospital, was released on Aug. 13th, since returning home, he has not been able to drink...whenever he takes sips, by the 3rd or 4th sip, he'll start gagging and then will regurgitate some saliva/liquid out along with whatever he's drank. He can eat, but if he drinks, then it'll bring back up whatever he's eaten say 2 hours ago. So, on Aug. 29th, he was admitted back to the hospital due to dehydration...since admitted, they did 2 swallow test to see what's happening...and said that everything looks fine anatomically and they also did an endoscopy to dilate the esophagus just incase that's the reason...but, he's been home since Sept. 2nd, and still can't keep liquid down...

HELP!!! Any suggestions, what did you go through...did it somehow resolve itself?

I'm thinking that he should ask for some Nexium?

Thanks for reading and all your help!!!
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Oct 1, 2011 @ 8:20 pm
Hi,
I had a 7 inch tumor on the bottom of my esophagus that was found in Jan 2011.I went through chemo and radiation(this process srunk my tumor down to 3 inches) in march and april and then I had surgery to remove most of my esophagus and part of my stomach.I asparated a tray of food in the hospital and they had to take a liter of fluild out of my lung.The phemomia I got was terrible and ever sence I went from 230 to 167 and in the last 8 months lost most of the muscle it had taken me 58 years to build up.Right now I can take the O2 off in the day but not at night and belive soon i wont have to have O2 at all.My doctor told me to stay away from eating most ruffages(salads and other vegtibles) I did but the throwing up would not stop One day I decided to eat some celery with peanut butter and this helped hold the bile down and since have found any kind of ruffage helps keep it down. I have good days and bad days but I guess that is to be expected. i wish I could of found some reading material that could of helped me through this nightmare but I found very limited resources. The doctors just say everyone is different so they stay out of trouble.The best help to keep food and liquids down have been 2 drugs they give me Dexliant a ant-acid and reglan a drug that helps food go through your digestion systom.My prayers are with all going through this nightmare and all those helping them go through it.Without support I would not have made it. So I hope this info may help and God bless!!
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Nov 17, 2011 @ 11:11 am
My husband was diagnosed with stage 3 esophageal cancer in February, 2011. He received 8 weeks of radiation and two 96-hour rounds of chemo during the months of March and April. At the end of May, he had an esophagectomy. They removed about 2/3 of his esophagus and 20% of his stomach. They stretched/reshaped his stomach to attach where the esophagus was removed. He was on a feeding tube for an additional 4 weeks after he was discharged from the hospital. He has gone from 237 pounds to 188 (so far). He had CT scans at the end of September and they were all CLEAN! He still has some difficulty eating/swallowing. If he eats too much at one time, he will most likely throw it up. It's been hard for him to take in enough calories. So far, he is actually okay with his weight as he is only about 5 foot 9 inches tall. So 188 is a good weight. BUT if he continues to keep loosing weight, we will have to do something about it. Other than that, he is doing absolutely great! I hope this give someone out there some positive thoughts and encouragement for recovery. It is true what the doctor's say about everyone being different. My stepbrother just passed away on Nov 8 from the same exact cancer. He too was diagnosed earlier this year.
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Nov 18, 2011 @ 5:17 pm
Hi my name is Daphne and my brother in law had his escohagus and part of his stomach removed due to cancer on July 25,2011. He was doing fine after surgery and eating fish, scallops and most normal foods and then started throwing up thick, foamy liquids. He went back to the hospital last week and had a scope put down. They stretched the new esophagus and removed some scare tissue but this didn't seem to help. If anyone can give us some kind of idea on how long this throwing up and recovery will take please let us know. Any kind of information will be very appreciated. Thanks so much, and our prayers and thoughts are with you all.
Dawn Potter
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Nov 23, 2011 @ 2:02 am
I had to have 1/3 of my esophagus and 1/3 of my stomach removed in Aug 09 due to a benign tumor at the GE junction which was closing off my esophagus.My surgery consisted of a midline belly cut. I went undiaganosed for 1 1/2 years while losing 30 lbs. I am 5'8" and weighed 132. by the time surgery i weighed 110. My tumor was in the lining and not detected with EGD. In the hospital 10 days and sent home with feeding tube for 3 weeks.Eating was horrible. Felt like swallowing bricks. 3 weeks post op i weighed 98 lbs adn felt like i was disappearing. i would eat 2 to 3 bites of food every hour trying to get nourishment. did ensures and high calorie smoothies for a long time. i never threw up (thank God, that petrified me) i coughed some in the early weeks trying to eat. had horrible hickups that felt like they were ripping me apart. i got up to 112 adn have recently started losing weight again. am down to 104. BUT i can eat and i can drink. i am on nexium for acid due to food coming back up the throat. the head of my bed is raised about 6". i eat small amounts 6 times a day and am very selective about what i eat due to acid reflux.i lost all my fat and most of my muscle. was a horrible surgery that took a full year for me to feel like i was going to make it thur. But i am alive and living. hope this gives some of you some encouragment. Was a hell of a road to travel but there is hope for you.
Joanna
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Dec 15, 2011 @ 1:13 pm
My dad had stomic cancer an had to get some of his esophagus takin out he has been doing ok but he has problems eating mostly everything he eats makes him sick he is in the hospital now because of the vary strong burning he gets a night it happens all the time but this time it was unbarable is there a certant diet he should be on PLEASE HELP
Shane Nielson
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Dec 22, 2011 @ 6:18 pm
I am a 43 year old male that was diagnosed with stage 3 esophageal cancer on August 30, 2011. I have never smoked, I don't drink and I have never had acid reflux. I'm just lucky I guess. I went through 6 weeks of aggressive chemotherapy and radiation. So far that has been the worst part of treatment. On December 1st I had 50% of my stomach removed, 33% of my esophagus and 28 lymphnodes This was done laparoscopically. I had some complications with blood pressure and heart rate immediately following surgery causing the surgeons to stop all pain meds for 12 hrs. That was not very pleasant. I was allowed to start a soft esophageal diet 8 days after surgery and was sent home 10 days after surgery. It is now 3 weeks after surgery. I'm not going to lie this has been the toughest thing I have ever gone through and fom what I was told I did extremely well following surgery. I have gone from 215lbs to 162lbs since diagnosis. The pain and eating are very difficult to deal with. On the positive side labs showed that chemo and radiation did their job. I have no active cancer present in my body. To those who have to go through this, keep a positive attitude, keep faith and allow friends and family to help you through this difficult time.
Judi Robcke
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Dec 23, 2011 @ 4:04 am
I will be having the surgery removing part of esophagus and part of my stomach in early January. The doctor informed me I will no longer have a stomach, it becomes part of my esophagus. From everything I have read from previous patients it is a horrible sugery and recovery, would anyone recommend going to a rehab facility instead of home for more help
with the feeding tube etc. A home health aid is also an option, any thoughts or suggestions
would be appreciated. Also, what are the restrictions in the type and or quantities of food I'll be able to eat?
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Jan 7, 2012 @ 1:13 pm
I had the Ivor-Lewis esophagealgastrectomy laproscopic/robotic procedure for adenocarcima at UAB by Cerfolio on July 18 which went very well. I underwent two subsequent lung surgeries and other complications, then made the mistake of being transferred to a rehab center. They don't have a clue about lung/respiratory issues - GO HOME and obtain all the gear you need for feeding and a hospital bed. Get good home healthcare providers to come to you. Since all of us react to the surgery differently, I can't advise on many of your questions. Your recovery is going to be slow, difficult and will be measured in months, not days. God bless you in the days ahead . . . .
cher1
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Mar 2, 2012 @ 7:07 am
hi every1 my dad had his esophagus removed last september and had his stomach attached up in his chest. He has been on a feeding tube since but has always been told that he will be able to eat again then this week on wednesday he was told he'll neve be able to eat or drink again and will be on a feeding tube fo the rest of his life as a family we are devasted because as yourselves we have struggled to get information about post operation information and although he has nothing by mouth for the last 26 weeks we were told that it was only temorary and to now be told hat he ll never eat or drink we are unable to accept, during bis post op treatment he has had no end of swallow tests and has been able to swallow banana and yoghurt during the test but had some trouble with liquid going dwn the wrong way at the moment i am trying to find informaton on new treatments and cures for this problem i would be gratfull for any help to find out were to go or look for help with him getting his ability to swallow , we are very lucky becus hiscancer was cught in time and all the cncer successfully removed but to be told you ll have a full recovery and for all the medical staff to continue telling you that you'll beeating soon and that you ll be eatin by the end of march 2012 its just crushed us and we are at a loss as to why everything has started to fall apart and we cannot comprehend what we ere told by the surgeons and now find ourselves without answers or resources to get this problem sorted
Taylor
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Apr 17, 2012 @ 1:13 pm
Hi my name is Taylor, I am 23 years old my mom has had acid reflux problems for awhile now, pneumonia twice in the last year, and noticable weightloss. It is hard for her to eat, and to keep food down. We have been told it is not cancer, her doctor told her about the surgery (where they will open her up and remove the esophagus) She doesnt know if she wants to do it right away because of the list of complications and survival rate. But She doesnt know how long it will be if she doesnt have the surgery because of weightloss ect. I know she is scared and so am I, because her dad passed away from esophageal cancer 11 years ago . If anyone one can give me any information, or let me know if you anything similiar going on to help me understand or other options she should talk to her doctor about that would be appreciated.
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May 29, 2012 @ 10:10 am
My husband 49 years old found out he had Barrett's Esophagus he had his esophagus removed he had high dyspepsia has not been right since vomiting diarrhea extreme pain quality of life is zero has any one else had these problems and found any help would like to hear from you he had this nov.2010 had a great dr but something has to get him some relief.

contact me at; chelton50@gmail.com
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Sep 25, 2012 @ 11:23 pm
I was diagnosed with esophageal cancer on June 2012. I went through 6 weeks of chemo and radiation treatment. I have lost more than 40 lbs. since the treatment. I am now being evaluated to undergo surgery. I have asked my encologist, radiologist and surgeon all kinds of questions regarding the surgery and I all the answers I got were basically unfavorable to me. I have also done some research on the Internet and found out that most people who went Through surgery are going through all kinds of difficulties. I would hate to live the rest of my life going through all kinds of complications due to the surgery. My questions are... Is there anyone out there who had a surgery done with good outcome and also how were you able to decide whether to have the surgery done or not? Your responses are very appreciated... Thanks David.
David
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Sep 25, 2012 @ 11:23 pm
Please respond to my email at dave5_30@yahoo.com thanks again David
Dave N
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Sep 30, 2012 @ 3:15 pm
Was diagnosed with tumor in eosophogus back in Oct 2011, went in for surgery on Jan 10th 2012, cant say it was aan easy time, home after 10 days then re admitted with a bowl dissorder,another 10 days, lost almost 2 stones thats about 30lbs. then was faced with what they termed as precautionary chemo? had probs with the chemo as I was just not strong enough, left it alone for 6 weeks then returned to 4 sessions of cesplatin, a very difficult time. Now?? finished treatment,prognosis is good (well great) getting on with life, back at work (locksmith) OK! eating aint the same anymore but have now put on weight
and happy happy to be alive.
Advice to all- stick with it you can beat it if you try.
Dr. Zakir Hossain
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Oct 30, 2012 @ 10:10 am
this is a good system. i like it very much. ok,if u m ention about the method of anastomosis after esophagogastrectomy, it would create extra dimention what we want. anyway, its a very good presentation.
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Nov 25, 2012 @ 12:00 am
I had mine removed last may & I don't have a feeding tube but I still have problems eating & can only drink apple juice nothing else & lists of pain & still get really sick after eating can anyone tell me when this will stop & if I will every be able to drink something other then apple juice ?
TB
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Mar 12, 2013 @ 9:21 pm
Hi, my brother had this surgery 19days ago. He is still in ICU as he is draining 100mls an hour of lymph fluid. His doctors are saying that he just has to wait until whatever damage caused to the Lymph area heals. Has anyone else had this problem and how long did healing take. They don't seem to be able to tell us. He is still not allowed to take anything by mouth as this increases the amount of drainage. He is being fed by drip only, not even by PEG feed tube. Naso gastric tube was removed a few days ago, there are no leaks from the somach or oesophagus and he was dry retching yesterday.
Dave
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Mar 17, 2013 @ 9:21 pm
I had an esophagectomy Nov 2010. I was draining lymph fluid heavely afterwords. A test was administered to determine were the leakage was and the extent of the damage. Leakage was a result of a damaged Thoracic Duct during surgery. I was immediatly scheduled for surgery to repair the Thoracic Duct. Surgery was succesful.
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Apr 11, 2013 @ 6:18 pm
Hello my names alison I'm 32 and from the uk I have oesophageal stricture in my neck which is not from cancer. My surgeon has stretched it 3x times 2 years ago and recently had to stretch it again. When it was first diagnosed it was 4mm and has now moved to under my voice box so in length now measures 8cm. I have not been able to find anyone who has had anything similar to me and as I am now considering surgery I am curious to see if there's anyone out there who can give me some advice.
marie j
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Apr 25, 2013 @ 1:13 pm
My husband had a partial esophagectomy 8/28/12. He has suffered ever since. The surgeon cut part of the lower esophoguse and upper stomach. Instead of moving up the stomach to the esophagus...he stretched the esophagus about 3-4" and reconnected to the stomach. My husband has not been pain free since this surgury. Has anyone heard of the surgery being done this way? Besides the stomach pains the esophagus is painful even when he is eating soup. and like clockwork...30-45 minutes after eating he gets bad pains in stomach. All the tests have been done. One coming up tomorros 4/26/13..small bowel follow thru which is a test that follows the barium through his digestive tract to see if anything was missed from the colonoscopies and upper endoscopies.
I am running out of options and my husband is giving up... He does not want to eat and he is very depressed.
Antonio F
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Apr 28, 2013 @ 9:09 am
I was diagnosed with cancer of the oesophagus last October 2012. I went through a tough regime of EOX Chemo from November 2012 to February 2013.I had three cycles as is normal here in the UK. I then had an Ivor-Lewis operation in early March
2013 which went very well and I had a wonderful team of doctors and surgeons who are very pleased with my progress.
I am a 70 year old male. All was going very well and I am now eating almost normal food but little and often, but I
still have to wash it down with lots of water. The problem is that I seem to have a lot of mucus, it feel like a hard ball
in my throat just as I am about to swallow [not near to the join] and it prevents me from swallowing
anything. I try and have soup and the same thing happens. The surgeon and oncologist didn't seem to be too worried
about this except to say it is a slow recovery and these things can happen. But it has got to the stage that
sometimes I just can't eat or drink anything. I certainly have to cough up the mucus before I can attempt to eat any more, usually it gets better later but at the moment it is very bad.
I was told that there was still some active tumor on a few lymph nodes around the stomach but they were confident that all
had been removed, my tumour was in the lower part of the oesophagus so part of the top part of my stomach was removed and
pulled up behind the rib cage. The surgeon who did this op is one of only a few who perform the Ivor-Lewis in the UK. and
very experienced. Is this just all part of the recovery and it is 2 steps forward and 1 back and sometimes 2 steps back and 1 forward!? Can anyone give me any advice. I am not on any medication, only Omeprazole to help the acid reflux. Many thanks.
Pat
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May 14, 2013 @ 2:14 pm
I had this surgery. Life after is challenging, but at least there is a life after. 5'8" white male, currently 54 y.o. Noticed painful swallowing in December 2010, weighed 185 lbs. Diagnosed by endoscopy (4/2011, weighed 175 lbs.), cancerous tumor at the stomach/esophageal junction, staged at T3N1Mx. Treatment was the MAGIC protocol: 3 rounds of chemo (done 7/2011, 160 lbs.)--en bloc esophagectomy, removal of the entire esophagus and 2/3 of the stomach (8/16/2011, 155 lbs.)--3 rounds of chemo (done 12/11, 135 lbs.) J-tube and night feeding until October 2011; stopped because of nausea associated with chemo (weight bottomed at 124 lbs.) J-tube removed in December after chemo completed and I maintained weight for 2 months.
Still not fully recovered, 4-6 hour work days but GRADUALLY improving. Little information as to what to expect or anticipate following surgery, but complications since: Several dilitations (stretching of the surgical junction) to allow food to pass. Constantly spitting up white frothy liquid for the first 3-4 months, but eventually subsided. Mucuos "lump" at the junction for 6 months, largely subsided but I still get it maybe monthly. Incisional hernia, repaired in July 2012. Still have acid reflux (burning in the throat, coughing), treating with omeprazole and carafate; largely controlled but still an issue. I sleep on a "wedge" which lifts my head/throat above my stomach but if I slide down while sleeping (1-2 times per month) the bile will escape my stomach and I'm up for a couple of hours dealing with that pain (Maalox helps.) Eating has steadily improved, up from a few bites after surgery, I can now eat about 1/2 of a regular meal each sitting, weight now stabilized at 140 lbs. Soft and moist foods are preferred because of the ease of eating, but chewing thoroughly allows consumption virtually everything. Hydration is a challenge because of capacity, kidney stone in 10/12 and kidney doc anticipates I'll have more. Still have digestive issues (weakness, discomfort) following each meal, regardless of quantity or type of food. Still have numbness and pain at the surgical sites (throat, abdomen, ribcage.)
Georg
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May 20, 2013 @ 2:14 pm
My wife (age 63) had chemo and radio until jan/2013, to treat a T1N1 cancer of the esophagus. On april 9 she underwent laparoscopic esophagectomy (and had part of the stomach removed). She lost almost no weight during radio/chemo (33/5 sessions, respectively). Things started getting worse after the end of radio, with difficulty to eat. Supplements helped a lot. Forty days have passed after surgery and she is on a liquid diet, taking a lot of supplements (we have the same here in Brazil as you do in the US). She has felt no post-surgery pain. We are worried with her diet. How long does it take, typically, to start on a semi-solid diet? And how long to get to solid? Until now, total weight loss is on the order of 13 lb. I would be glad to read comments.
Georg
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May 20, 2013 @ 2:14 pm
In response to Antonio F (#42, above): my wife is also on Omeprazole, but also on Bromopride (to help the motility of the new esophagus). She sleeps on a 30-degree angle, to avoid reflux. After radio and now, after surgery, she is taking some phytotherapic medication. This medication surely helped in the healing process after radio
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Jul 16, 2013 @ 2:02 am
I had my esophagus removed 2 May 2005 @ the IU MED Center in Indianapolis by Dr. Kessler. My concern is I still have acid re flux when I lay down at night. My new care taker at the Marion VA tells me it is impossible for the re flux to get into my lungs. I explain what is happening and how hard it is to cough it out and how long it takes to do this. He tells me the re flux is in my esophagus and I tell him I don't have one anymore. Dr. Kessler told me my stomach is attached right to my throat. Has anyone else had problems with aspirating of re flux? Is there anything that can be done? I do have the head of my bed elevated with 10 2x4's which give me about 8 inches. I also take Omeprazole SA 20 mg. 2 x daily.
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Jul 16, 2013 @ 6:18 pm
Please refer to my note 45, above, about elevation. My wife sleeps on a 30 degree "ramp" that assures more than 8 inches. She has no reflux. Herre in Brazil we are told to avoid reflux, by all means.
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Jul 20, 2013 @ 1:13 pm
Hi Everybody, I had my Esophagectomy done in April of 2013. I was very lucky, in that the VA. Hospital decided to give me a Endoscopy, after I complained about having heart burn most of my adult life. 15 years earlier, I volunteered for a Clinical Trial Study for heart burn. I was warned then, to take acid reflux prevention medicines as I had Barrett's then. Needless to say I ignored the warning. Although they did showed me my Gerd was from my own poor eating habits. I changed when and what I ate. I believe, that's why I lasted so long before cancer developed The VA found the cancer and I had to have the procedure done. I again was lucky the cancer had spread to the outside wall of my esophagus, but they say, no further. MY only problems have been weight loss. 30 lbs, so far and still dropping. The worse problem has been while eating food. I cough constantly. No matter what I eat I cough continually. Quite embarrassing in a restaurant. I do eat through my feeding tube at home. Jevity and Whey Weight Gain. I still had heart burn and noticed I was eating a piece of root beer barrel candy before I went to sleep. The burn stopped when I stopped the candy. I have to watch out for Depression.
Steven Bott
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Jul 23, 2013 @ 3:15 pm
I had Ivor Lewis surgery in February of 2012. I was originally diagnosed with cancer in my upper stomach and lower esophagus in October of 2011. My treatement started with radiation and chemo in November of 2011. I had lost about 25 pounds during that treatment and the doctors gave me several weeks to regain some weight before surgery. After the surgery I was on a feeding tube for about ten weeks total. (3 weeks in the hospital and 7 weeks at home) I also started post surgery chemo from late May into the end of July. My main problems were 1) Getting enough calories to gain weight 2) Throwing up and 3) A numb area on my right side. I am happy to say that every one of these things has gradually gotten better with time and learning on my part. I eat several smaller meals a day and try not to eat too much or too fast no matter how good something taste to me. It took a while to identify the types of foods that work best but I have gained a lot of knoweledge in the last year and one half and now I seem able to get enough food most of the time and keep it down the vast majority of the time. I still try do have occassional situations where I throw up mucous and food but I have been able to get that down to once every couple of weeks at this point and I can live with that. I try to eat slow and if I start feeling sick I stop eating immediately and wait for a while. I have gained weight back and I am now up to 195 from a low of 167. (I used to weigh 235 before the surgery) The numbness is still there but it seems to be getting better. I now have more of a soreness than a numbness but I think that will eventually get better as well. I still cough more than I used to, I do have periods of time when eating is more difficult than others and I have to be careful with my eating habits. All in all though, I am happy I had the surgery. I have had a PET Scan every six months now for a year and a half and so far (knock on wood) there are no signs of any recurrence. It has been very difficult but having the surgery certainly is better than the alternative.
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Jul 23, 2013 @ 3:15 pm
One other thing to add. I do have to sleep partially angled or "sitting up." I have accomplished this by finding the right combination of pillows through trial and error. This has largely prevented me from having to deal with reflux for the most part. I try not to eat solid food within two hours of bed time. If I feel that I have to eat I try and make is something very light and very bland that will curb the empty feeling with just a few small bites.
Renee
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Sep 4, 2013 @ 6:18 pm
Hello,

My mom had her esophagus removed in 2009 and has not had to many issues since the surgery. She still has acid reflex and also like most stories I have read sleeps sitting up but this is no different than before the surgery. A plus side she has less acid attracts than she had before surgery. I am reaching out because her biggest side affect is keeping her blood sugar up it is not uncommon for her to drop into the 40's at least once a day and she has been as low as 35. No one seems to have any answers for her so I am hoping there is someone that might be able to help.
Shelly
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Sep 22, 2013 @ 7:19 pm
MY HUSBAND IS STATUS POST ESOPHAGOGASTRECTOMY 9/4/13 AND IS HAVING TROUBLE SLEEPING, NOT DUE TO REFLUX BUT LUNG CONGESTION. IS THIS A SIDE EFFECT FROM THE SURGERY AND WILL IS LESSEN AS TIME GOES BY?
mamta kakkar
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Sep 29, 2013 @ 7:07 am
my mom got operated 11 months ago but still can't eat properly .the reason may be gastrointestinal . what to take to avoid the loose motion and vomiting ?
georg
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Oct 7, 2013 @ 8:20 pm
I still have qualms about the diet. My wife lost 10 kg (22 lb) and has not been able to recover more than 500 grams (1lb), taking all kinds of supplements, eating some chocolate, ice cream, peanut sweets, etc. She's eating a lot of protein, contained in the supplements (like Whey Protein, for example). Doctors and nutritionists don't seem to know why she's not gaining weight ("that's the way it is"). Does anyone have the same kind of experience? When do you start recovering weight? When, if ever, do you stop feeling that you underwent surgery? Do you recover all the weight you've lost?
Pat
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Oct 14, 2013 @ 1:13 pm
@georg: I was 185 lbs. when I first started getting symptoms, 155 following surgery and 124 following final chemot treatment. I have worked hard to raise my weight to around 138-140. No supplements, but I do eat mostly foods high in calories. A little over two years now since the surgery and I anticipate this will be my weight from now on. Since I have little or no appetite and also experience digestive discomfort after I eat, even maintaining my weight requires focus and conscious effort. Recently, I have been given a prescription for Creon, which are digestive enzymes that seem to help with the digestive discomfort somewhat.
kl1
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Nov 4, 2013 @ 9:09 am
My Mom is a 63 y.o. and had the upper half of her stomach and lower portion of her esophagus removed due to a large GI Stromal Tumor. We had no other options at the time because the tumor had caused a bleed that could not be permanently stopped any other way. It has been very difficult for her, but now, seven months later, her weight is stable (a nearly 40 pound loss overall)and she is learning to cope with the new normal. For months after the surgery she vomited frequently, had swallowing difficulties and lost several pounds per week. Now she can eat, just a much smaller amount. She does not have reflux issues very often, but she does still vomit at times and has some swallowing difficulties if she eats too quickly, does not chew well or chooses something that causes problems. She has had a lot of problems since the surgery with dumping syndrome, but that's more a stomach removal issue than esophagus. I don't think she will ever gain the weight back, but she is a healthy weight now, so that's for the best in our case. We did use high protein foods and supplement powders for awhile until she stabilized. Once she stopped losing weight and actually gained a little back, we went to a normal diet. I feel for all of you who are not getting answers from doctors and nutritionists---we really didn't get many answers either, except to pump in a lot of protein and wait it out. My feeling is that this type of surgery is a real body shock, and doctors cannot really prepare for how any one person will do---some people simply do better than others. You must have an iron will to get through the tough parts of this, and try to think positive. It will get better, and you will find ways to make your own situation better for you. If you feel that something is not right and cannot get help with it, keep trying! We asked every doctor or professional that we could get to talk to us. Always pursue what you need, and use the info you are given from those you trust. This procedure saved her life, so as difficult as it was at times, we try to remember that and keep moving forward. No one would choose this, but, it can be manageable, and she has many good days and a few not so great. Family and caregivers---stay positive for your loved one, and know that things will get better. Best wishes to you all for a speedy recovery.
Shawn
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Nov 11, 2013 @ 7:07 am
Hi im a 38 yr old female and i have very bad acid reflux. I get my esophagus dialated yearly because foods and liquuds get stuck. The thorasic surgeon said that the lining of my esophagus have openings(hole) in it. My spincter muscle barely works. Lately whenever I eat i have severe stomach pain and chest pain for the next few hours. Most of the time the acid from my stomach comes up and burns my throat. The surgeon wants to remove my esophagus and pull my stomach up to create me a new one but my rhuematoid doctor dont want me to have the surgery. She says its a tough surgery to go through so young. Im a scared & nervous about the post surgery. Will i be able to eat? Will i every be able to function normally again? Im dont know what to do. Im so tired of being in pain. I have tried 5 different acid reflux meds, changed my eating habits, and sleep @an angle. Us there anything else i should or can try before i do the surgery? Email me @ restored2new@yahoo.com any suggestions or advice that will ease my mind about the surgery. Put in subject esophagus surgery please & thank you.
AD
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Nov 19, 2013 @ 10:22 pm
Dear Shawn
im 60 y.o male i had this surgery done in 2011 and im telling u its easy surgery i mean the recovery from it its been 2 years since i had it done n ill still cant eat right or anything i want to eat as normal people i still having food backing up my esophagus n burn my throat n burn me like hell or sometimes shock n i cant breath getting up in the middle of the night. not to mention the pain n discomfort, and not able to sleep laying down i sleep in a sitting position so the food wont back up to my esophagus or my throat n its very tiring , n ill tell u the side effect of it too mostly u will have dumping syndrome n bad heart burn n you will lose ur spincter valve .i took lots of anti acid meds none helped me.
Try to sick to a good diet soft food dont smoke or drink alcohol , best thing for ur acid reflux n it will work right away is make a lemonade the put small amount of baking soda in it n wait till it bubbles the drink it.it will work right away , i tried it n it works.
and listen to ur rhuematoid n get a second opinion.
my advice to u dont have it done coz ill make u get worse try a good soft diet
Glenn
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Feb 17, 2014 @ 3:03 am
As we all do, i've been reading everything I can on this blight since I first got the news last Friday 13th of September - how ironic was that!
Staging suggested I was at stage 3, with one lymph node impacted. This was enough for my doc to OK an esophagectomy. Ahead of this he got me onto nine weeks of chemo, which went surprisingly well - not so much from a curative perspective...it just didn't knock me about as bad as i'd expected.
The op took place on January 21, so today i'm one day shy of four weeks post-op.
I know that's nothing compared to many of you survivors, but after some of the tough prognoses i've read here recently, I just wanted to let anyone approaching their own op (with understandable trepidation) to know, if i'm anything to go by, its not all doom and gloom.
I've been eating solids now for almost two weeks. I'm doing the "eat a little, eat it often" approach but i'm already finding my portion sizes and opportunities to eat are increasing.
Take today...I started with aa glass of freshly squeezed juice (mango, apple, banana, carrot, beetroot and ginger) at 5.00 (i'm an early riser) ahead of a 30 minute walk. At 6.30 I had what i'd call a half serve of home-made cream of chicken soup. At 9.00 I had a half serve of german sausage and baked beans ahead of a session hitting golf balls (i'm a golf tragic and i've been told its ok for me to ease back in).
Come 11.30 it was a half serve of a lasagne I made yesterday...plenty of chewing but it went down a treat. This afternoon, after my siesta, I had a small bowl of icecream and some crackers with cheese. I'll end the day eating at about six, with a bowl of greek yogurt and mashed banana - my "baby food" indulgence.
So eating has gone well. I'm even managing a glass of white wine mid-afternoon as a treat. I've found the only problem my stomach causes is if I eat too much, too late in the day, so i'm making sure I avoid testing this out too much. If I do, its primarily stomach cramps that get me - though usually for no longer than an hour.
I've been lucky with dumping - i've had it once, and that was triggered by a necessary sugar hit (cocolate and flavoured milk) when my blood sugars dived one evening (i'm a 55 year old male insulin-dependent diabetic). Reflux has also been a rare visitor, thank heavens. Its woken me up once at night - coughing up bile is never any fun, but a glass of milk and a strong mint did the trick.
So there you have it...a month out, still no way near through recuperation, but life already feels like its establishing a new, reasonably acceptable, normal.
Hope that helps any of you approaching the op - I can't guarantee this will be what you experience, but I can tell you that it might.
Wilma colquhoun
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Mar 20, 2014 @ 7:19 pm
I had surgery to remove large part of gullet and half stomach and suffered with two hospital acquired bugs,,, staph Aurias and clostridium diff, both became life threatening but were eventually brought under control. Pain was horrific after surgery and morphine etc hardly touched it, I now have nerve damage and still on morphine fentanyl as before that the oxycodone and oxymoron travelled too fast through the new plumbing and was still a solid tablet in the toilet bowl, the surgery was open abdominal and open under right breast and around to the side and up my back and the vagus nerve was damaged causing central apnoea where I stop breathing both day and night and have a res med auto wave machine to keep me breathing and an oxygen machine too, as to eating it is mostly the same for all of us, must be toddler portions and never never a spoonful more as new plumbing can not deal with it, otherwise the frothy stuff that just keeps coming,, it looks like half whipped egg white and fills up the whole place making keeping food down impossible, don't touch butter Margery oil tomato mushrooms garlic or stodgy desserts and sugar heavy sweets, chocolate makes mucus worse, use a pillow wedge and get used to sleeping upright, not enough information is available but I did my own research and am building up more because of my own perilous journey and a psychologist is valuable to help you and the rest of the family learn coping skills in the hard times, feel free to contact me and there is a great support organisation of patients and medical professionals in the uk and it's called OPA and they give advice and if you are local to the groups they can phone and visit you and you can go meet up with others,,, hugs from me,,,wilma Scottish wife mother and grandmother nine year survivor with unique plumbing,
Theresa Vogt
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Sep 30, 2014 @ 3:03 am
Hi,
I had my esophagus removed on the 4 Sept 2014. (Donald Gordon Hospital. Johannesburg).I presented with suspect cancer of the esophagus. (I was diagnosed FEb 2014 and had intense 6 months chemo to shrink the tumors).
MY surgery lasted 10 hours I was in I.C.U. (Intensive care) for 24 hours.My main discomfort was the two 15mm tubes draining my right lung and the tubes down my throat.The pain was huge but with each physiotherapy session and constant movement I felt exhausted and encourage that I would improve. The removal of the lung drains and tubes down my throat were so relieving. The pain was intense but manageable with regular intervals of medication. I tried to walk as much as possible once the drains and every second clamp from surgical wound were out. My trip to the X-ray department to check my swallowing results was so humbling and joyful. I spent 10 days in hospital. I am currently at home recovering. The discomfort and internal pain is a reminder of my good fortune. I am cancer free.
I have been fully reintroduced to food I started of with stage 2 - clear fluids. Stage 3 - Mixed fluids. Stage 4 - Purée Diet. Stage 5 - Soft Diet. I am now enjoying a carefully planned soft diet. Good luck to you if you are following in my footsteps...go for it and no pain no gain.
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Oct 1, 2014 @ 12:00 am
Hi,
Just read Theresa post. Jackie (my wife) here on the Gold Coast in Australia has had her esophagus removed in June 2014. Very similar progress as Theresa. We are now almost 4 months down the line and Jackie is swimming daily (1km when she can)and playing tennis.She has had her throat dilated on 2 occasions. The biggest problem since the dilation is re-flux. We are playing with Nexium 20mg up to 40mg. 40mg caused nausea,so reverted back to 20 mg. Jackie never feels hungry so we have to constantly change diet trying to find foods that reduce reflux. We took a sea cruise for the food variety and always being available, I suggest this as a great get away and use the experience to test foods to suite you. As reflux seems to be a common problem, we should get together and solve this ourselves as there is nobody else who can. If anyone has any suggestions please let us know.

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