Esophagectomy
What is Esophagectomy ?
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Why do you need Esophagectomy ?
Esophagectomy is indicated for:
- Esophageal cancer:
- Squamous cell carcinoma (common in India, linked to smoking, alcohol, 60–70% of cases).
- Adenocarcinoma (often from Barrett’s esophagus, 30–40% of cases).
- Stages I–III (5-year survival: 20–50% depending on stage).
- Benign conditions:
- Severe Barrett’s esophagus with high-grade dysplasia (precancerous).
- End-stage achalasia (motility disorder) or strictures unresponsive to other treatments.
- Esophageal perforation or severe trauma (rare).
- Associated treatments:
- Often preceded by neoadjuvant therapy (chemo/radiation) for cancer (stages II–III).
- Lymph node dissection to stage cancer and reduce recurrence.
- Timing:
- Performed in adults (average age 60–70 years at diagnosis); urgency depends on cancer stage or condition severity.
The procedure aims to remove diseased tissue, prevent cancer spread, and restore swallowing function by reconstructing the digestive tract, often using minimally invasive techniques to reduce recovery time.
Why Do Esophagectomy Costs Vary in Philippines?
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Esophagectomy Procedure
- Before Surgery Evaluation:
- Assessment:
- Endoscopy/biopsy: Confirms cancer type, location, and extent.
- Imaging: CT/PET scan to stage cancer and check for metastasis.
- Blood tests: Liver function, clotting profile; nutritional status (albumin).
- Pulmonary function tests: Assess lung capacity (thoracic surgery risk).
- Preparation: Nutritional optimization (often malnourished patients); neoadjuvant therapy (if indicated).
- Consent: Risks, including leaks, are explained.
- Assessment:
- Surgical Techniques:
- Esophagectomy:
- Performed under general anesthesia, lasting 4–8 hours.
- Approaches:
- Transhiatal esophagectomy: Incisions in abdomen and neck; esophagus removed through diaphragm; less lung trauma.
- Transthoracic (Ivor Lewis): Incisions in abdomen and chest (right thorax); better for mid-esophageal tumors and lymph node dissection.
- Minimally invasive esophagectomy (MIE): Laparoscopic/thoracoscopic; smaller incisions (5–10 mm); reduces recovery time.
- Process:
- Esophagus resected (partial or total); nearby lymph nodes removed.
- Reconstruction: Stomach pulled up (gastric pull-up) or colon/small intestine used to form a new conduit.
- Anastomosis: New conduit connected to remaining esophagus or pharynx (in neck or chest).
- Closure: Sutures/staples; chest tube (transthoracic) and abdominal drains placed.
- Intraoperative Tools:
- Endoscope: Visualizes esophagus.
- Staplers: Creates anastomosis.
- Thoracoscopic tools: For MIE.
- Esophagectomy:
- After Surgery:
- Hospital stay: 7–14 days.
- Care: ICU for 1–3 days; nasogastric (NG) tube for 5–7 days; feeding tube (jejunostomy) for nutrition.
- Pain management: Moderate to severe pain for 5–7 days; managed with epidural or IV painkillers.
- Instructions: Avoid oral intake initially; chest physiotherapy to prevent lung complications.
Recovery After Esophagectomy
- Hospital Stay: 7–14 days.
- Post-Surgery Care:
- Pain/Swelling: Moderate pain for 5–7 days; resolves in 2–3 weeks.
- Nutrition: Feeding tube for 2–4 weeks; oral intake (liquids) starts at 5–7 days if no leak; soft diet by 4–6 weeks.
- Activity: Avoid strenuous activity for 6–8 weeks; light walking within 3–5 days to prevent clots.
- Tubes: Chest tube removed in 5–7 days; NG tube out in 5–7 days; jejunostomy tube removed in 4–6 weeks.
- Monitoring: Swallow study at 5–7 days to check for leaks.
- Follow-Up:
- Visits at 2 weeks (check healing), 1 month, and every 3 months for 2 years (cancer recurrence risk).
- Endoscopy/CT: At 3–6 months to monitor for recurrence.
Most resume normal activities in 6–8 weeks; full recovery takes 3–6 months. Success rate: 90–95% for complete tumor removal in early stages; 5-year survival for cancer varies (20–50%, depending on stage).
Risks and Complications
- Surgical Risks:
- Bleeding (2–5%): During surgery; may need transfusion.
- Infection (5–10%): Wound or chest (pneumonia); treated with antibiotics.
- Anesthesia risks (<1%): Reaction to general anesthesia; rare in healthy patients.
- Post-Surgery:
- Anastomotic leak (5–10%): At connection site; may need reoperation or drainage.
- Pneumonia (10–20%): Due to lung manipulation; prevented with physiotherapy.
- Chyle leak (1–3%): Lymphatic fluid leak; may need surgical repair.
- Vocal cord paralysis (1–3%, transhiatal): From nerve injury; often temporary.
- Long-Term:
- Reflux/dumping syndrome (10–20%): Food moves too quickly; managed with diet changes.
- Recurrence (20–40%): Cancer return; needs regular monitoring.
- Stricture (5–10%): Narrowing at anastomosis; may need dilation.
Report fever, severe pain, difficulty swallowing, or breathing issues promptly.
Frequently Asked Questions (FAQs)
What causes the need for esophagectomy?
Esophageal cancer (most common), severe Barrett’s esophagus, or benign conditions like achalasia or strictures.
Can I avoid esophagectomy?
Yes, if early: Endoscopic resection for superficial cancers; surgery needed for advanced cancer or severe benign conditions.
Is esophagectomy painful?
Moderate to severe pain for 5–7 days, managed with medication; resolves in 2–3 weeks.
How soon can I resume normal activities?
Light activities: 2–3 weeks; full recovery: 3–6 months; avoid strenuous activity for 6–8 weeks.
Is esophagectomy covered by insurance in India?
Often covered (medical necessity); confirm with your provider; Ayushman Bharat often subsidizes.
Signs of complications?
Fever, severe pain, difficulty swallowing, or breathing issues.
Will I be able to eat normally after surgery?
Yes, eventually: Small, frequent meals; soft diet for 6–8 weeks; some dietary adjustments long-term.
Lifestyle changes post-surgery?
Eat smaller meals, avoid lying down after eating, quit smoking/alcohol, and attend follow-ups.
Conclusion
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Looking for Best Hospitals for Esophagectomy
Note: we are not promoting any hospitals
We do not promote any hospitals. All details are sourced from Google and hospital websites. Please verify independently. Start with your surgery—here’s the list of government, budget, and superspecialty hospitals accredited by the Department of Health (DOH), Philippine Health Insurance Corporation (PhilHealth), and Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₱) | Maximum Price (₱) |
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Angeles City |
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Antipolo |
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Bacolod |
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Bacoor |
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Baguio |
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Butuan |
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Cagayan de Oro |
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Caloocan |
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Cebu City |
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Dasmariñas |
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Davao City |
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General Santos |
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General Trias |
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Iligan |
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Iloilo City |
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Las Piñas |
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Makati |
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Malolos |
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Manila |
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Muntinlupa |
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Parañaque |
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Pasay |
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Pasig |
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Puerto Princesa |
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Quezon City |
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San Fernando |
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San Jose del Monte |
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Taguig |
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Valenzuela |
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Zamboanga City |
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Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.