Men and women of all ages can have esophagus disorders. The most common symptoms of esophageal disorders are dysphagia (an awareness of swallowing difficulty) and chest and back pain. Dysphagia and chest or back pain may occur in any esophogeal disorder, the most serious being esophogeal cancer.
- Esophogeal cancer
- Gastroesophageal reflux disease(GERD)
- Barrett’s esophagus
Surgery for Cancer of the Esophagus
Surgery to remove some or most of the esophagus is called an esophagectomy. Often a small part of the stomach is removed as well. The upper part of the esophagus is then connected to the remaining part of the stomach. Part of the stomach is pulled up into the chest or neck to become the new esophagus. How much of the esophagus is removed depends upon the stage of the tumor and where it’s located.
Minimally Invasive Esophagectomy
For some early (small) cancers, the esophagus can be removed through several small incisions instead of 1 or 2 large incisions. The surgeon puts a scope (like a tiny telescope) through one of the incisions to see everything during the operation. Then the surgical instruments go in through other small incisions. In order to do this type of procedure well, the surgeon needs to be highly skilled and have a great deal of experience removing the esophagus this way. Because it uses smaller incisions, minimally invasive esophagectomy may allow the patient to leave the hospital sooner and recover faster.
Surgery for Gastroesophageal Reflux Disease (GERD)
There are a number of treatment options for patients of GERD or gastroesophageal reflux disease that vary depending on the extent of the condition. But when the condition has developed into a more serious stage, a surgical procedure might be required. If you are diagnosed with this condition and had been recommended for surgery, it is important to understand what are the various types of surgery that you might undergo. The most common type of surgery recommended for GERD patients is known as fundoplication.
During fundoplication surgery, the upper curve of the stomach (the fundus) is wrapped around the esophagus and sewn into place so that the lower portion of the esophagus passes through a small tunnel of stomach muscle. This surgery strengthens the valve between the esophagus and stomach (lower esophageal sphincter), which stops acid from backing up into the esophagus as easily. This allows the esophagus to heal.
Surgery for Barrett’s Esophagus
Barrett’s esophagus is a serious complication of GERD, which stands for gastroesophageal reflux disease. In Barrett’s esophagus, normal tissue lining the esophagus — the tube that carries food from the mouth to the stomach — changes to tissue that resembles the lining of the intestine. About 10%-15% of people with chronic symptoms of GERD develop Barrett’s esophagus.
Surgical removal of most of the esophagus is recommended if a person with Barrett’s esophagus is found to have severe dysplasia or cancer and can tolerate a surgical procedure. Many people with Barrett’s esophagus are older and have other medical problems that make surgery unwise; in these people, the less-invasive endoscopic treatments would be considered. Surgery soon after diagnosis of severe dysplasia or cancer may provide a person with the best chance for a cure. The type of surgery varies, but it usually involves removing most of the esophagus, pulling a portion of the stomach up into the chest, and attaching it to what remains of the esophagus.