What is an oesophagectomy?

An oesophagectomy y is the removal of all or part of the food pipe (oesophagus) through an abdominal cut, a cut in the chest and/or a cut in the neck. The remaining food pipe will be joined to the stomach.

Anaesthetic

This procedure may require an anaesthetic.

What are the risks of this specific procedure?

There are risks and complications with this procedure.
They include but are not limited to the following:

General risks:

  • Infection can occur, requiring antibiotics and further treatment.
  • Bleeding could occur and may require a return to the operating room. Bleeding is more common if you have been taking blood thinning drugs such as Warfarin, Asprin, Clopidogrel (Plavix or Iscover) or Dipyridamole (Persantin or Asasantin).
  • Small areas of the lung can collapse, increasing the risk of chest infection. This may need antibiotics and physiotherapy.
  • Increased risk in obese people of wound infection, chest infection, heart and lung complications, and thrombosis.
  • Heart attack or stroke could occur due to the strain on the heart.
  • Blood clot in the leg (DVT) causing pain and swelling. In rare cases, part of the clot may break off and go to the lungs.
  • Death as a result of this procedure is possible.

Specific risks:

  • Deep bleeding in the abdominal cavity could occur and this may need fluid replacement of further surgery.
  • A very serious problem is a breakdown of the bowel anastomosis which causes leakage of stomach and duodenal secretions with very severe problems of infection in the chest and this can cause death.
  • Damage of the bowel may occur which may cause leakage of bowel fluid. This may require further surgery.
  • Infections such as pus collections can occur in the abdominal cavity. This may need surgical drainage.
  • The bowel movement may be paralyzed of blocked after surgery and this may cause building up of fluid in the bowel with bloating of the abdomen and vomiting. Further treatment may be necessary for this.
  • A weakness can occur in the wound with complete or incomplete, bursting of the wound in the short term, or a hernia in the long term. This may need further surgery.
  • There may be difficulty in swallowing after the operation. Usually treated with being stretched.
  • There may be nutritional problems after the surgery e.g. anorexia, low iron, loss of weight and recurrent bilious vomiting.
  • In some people, healing of the wound may be abnormal and the wound can be thickened and red – a keloid scar and the wound may be painful.
  • Adhesions (bands of scar tissue) may form and cause bowel obstruction. This can be a short term or a long term complication and may need further surgery.
  • There may be a recurrence of the problem despite adequate surgery.
  • Increased risk in smokers of wound and chest infections, heart and lung complications and thrombosis.