Surgery is often recommended if oesophageal cancer has not spread to other parts of the body.
Learn more about:
- Overview
- How the surgery is done
- Oesophagectomy (surgical resection)
- Risks of oesophageal surgery
- Endoscopic resection for oesophageal cancer
- What to expect after oesophageal surgery
- Feeding tubes
Overview
The aim is to remove all of the cancer while keeping as much healthy tissue as possible. The surgeon will also remove some healthy tissue around the cancer (a margin) to reduce the risk of the cancer coming back in the future.
Depending on where the tumour is growing and how advanced the cancer is, you may have an endoscopic resection or an oesophagectomy.
How the surgery is done
To remove the cancer, the surgery can be done in 3 ways:
| Open surgery | The surgeon makes a large cut in the chest and the abdomen, and, sometimes, a small cut in the neck. |
| Keyhole surgery | The surgeon makes some small cuts in the abdomen and/or between the ribs, then inserts a thin instrument with a light and camera (laparoscope) into one of the cuts to see inside the body. Sometimes a small cut is made at the base of the neck on the left side. |
| Robotic surgery | A type of keyhole surgery where the surgeon uses robotic tools to remove cancer from the oesophagus through small cuts in the abdomen and/or chest |
Your surgeon will talk to you about the best type of surgery for you.
Oesophageal cancer surgery is complex. Surgeons who regularly perform this type of surgery have better outcomes. If you live far from a specialist centre, you would have to travel to have surgery. You may be eligible for help with travel costs. For more information, call Cancer Council 13 11 20.
Oesophagectomy (surgical resection)
Surgery to remove part or all of the oesophagus is called an oesophagectomy. Nearby affected
lymph nodes are also removed. Many people have chemotherapy before and after surgery, as this
approach has been shown to have better long-term results. Your treatment team will recommend the best option for you.
Depending on where in the oesophagus the cancer is, the surgeon may also remove part of the upper
stomach. This is the preferred option for cancer that has spread deeper into the wall of the oesophagus
or to nearby lymph nodes.
Once the parts with cancer have been removed, the stomach is pulled up and rejoined to the healthy
part of the oesophagus. This could be in the upper chest area or in the neck. The surgery will
allow you to swallow and, in time, eat relatively normally.
Risks of oesophageal surgery
As with any major surgery, oesophageal surgery has risks and side effects. These may include infection, bleeding, blood clots, damage to nearby organs, leaking from the joins between the oesophagus and stomach or small bowel, pneumonia and voice changes. Some people may have an irregular heartbeat, but this usually settles within a few days.
Surgery can sometimes cause scars that narrow the oesophagus. This is called oesophageal stricture and may make it difficult to swallow. If the oesophagus becomes too narrow, your doctor may need to gently stretch it (called dilatation).
Endoscopic resection for oesophageal cancer
Endoscopic resection is a way for doctors to remove tissue from the oesophagus without needing more major surgery. A thin tube is passed through the mouth and into the oesophagus. An endoscopic resection helps with diagnosis and staging. For some people with early-stage oesophageal cancer, it may also treat the cancer by removing the whole tumour.
An endoscopic resection is often done as a day procedure but in some cases, you may need to stay in hospital overnight for observation.
→ READ MORE: What to expect after oesophageal surgery
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Prof David Watson, Matthew Flinders Distinguished Professor of Surgery, Flinders University, and Senior Consultant Surgeon, Oesophago-Gastric Surgery Unit, Flinders Medical Centre, SA; Prof Bryan Burmeister, Senior Radiation Oncologist, GenesisCare Fraser Coast and Hervey Bay Hospital, QLD; Dr Natalie Collier, Radiation Oncologist, Wollongong Hospital, NSW; A/Prof Melissa Eastgate, A/Executive Director, Cancer Care Services, Royal Brisbane and Women’s Hospital, QLD; Natalie Lalor, 13 11 20 Consultant, Cancer Council Victoria; Chris Menzies, Upper GI Cancer Nurse Consultant, Flinders Medical Centre and Southern Adelaide Local Health Network, SA; Tammy Milne, Consumer; Stefanie Simnadis, Clinical Dietitian, St John of God Subiaco Hospital, WA; Prof Rajvinder Singh, Professor of Medicine, University of Adelaide, and Director, Gastroenterology Department and Head of Endoscopy, Lyell McEwin Hospital, SA.
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