Esophagectomy is a surgical procedure that involves excision of the majority of the esophagus and part of the proximal stomach, usually as a treatment for esophageal carcinoma or carcinoma of the gastric cardia, although benign conditions (e.g. stricture) may - rarely - be treated with this approach.
Esophagectomies are usually classified as either:
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transthoracic esophagectomy: more complete oncologic approach, higher pulmonary complication (each procedure requires a thoracotomy) and anastomotic leak risk
left thoracoabdominal approach
There are also different types of esophageal interposition:
gastric pull-up (most common)
jejunal interposition
Complications
These surgeries are technically demanding and have a high complication rate. Complications depend on the type of esophagectomy, but include
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pulmonary complications, esp. with a transthoracic approach
highest mortality rate
-
leak (with possible subsequent mediastinitis)
anastomosis (most common site)
gastric staple line
at pyloroplasty
recurrent laryngeal nerve injury
hemorrhage
delayed gastric emptying - gastric outlet obstruction
recurrent disease
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