What is an En Bloc Esophagectomy?
An En Bloc Esophagectomy is done in patients who are being treated for cancer of the esophagus. It is a radical operation that takes out the esophagus, a portion of the stomach and all of the lymph nodes in the chest and abdomen. The surgery is done through the neck, chest and abdomen. An incision is made on the right chest and the esophagus is mobilized. All of the lymph nodes are taken out of the chest. An incision is then made on abdominal wall and small incision is placed in the left neck. The stomach and esophagus are mobilized and all of the lymph nodes are removed from the abdomen. The stomach is cut into the shape of a tube using surgical staples. The esophagus and cut portion of the stomach are pulled out through the neck incision and removed. The newly shaped stomach is brought up through the chest and sewn to the small piece of the esophagus that is left behind in the neck. The stomach will now function as the esophagus used to.

Will I need to have anesthesia?
Yes.

How long will it last?
The surgery takes about 6-8 hours.

Will anything be removed, replaced, etc?
Yes, the esophagus is removed and replaced with the stomach. Sometimes it is necessary to replace the esophagus with the colon, small intestine or a piece of skin taken from the forearm.

Where will the incision(s) be made?
An incision is made on the back of the right chest, the abdominal wall and the left neck.

Will any devices/sutures/staples be implanted and will they need to be removed?
Permanent sutures will be used to sew the esophagus to the stomach and surgical staples will be used to fashion the stomach into a tube.

Will I have any tubes or drains after surgery?
Yes, you will have a small tube coming out of your nose that drains the fluid in your stomach. It will be removed 5 days after surgery. You will also have a drain in your right chest that will come out in 3-5 days. A small drain will be in your neck and will be removed 1-2 weeks after surgery in the doctor’s office. You will have a small feeding tube in your stomach that you will go home with and use it to supplement your feeding and medications. It will be removed approximately 2 months after surgery once you are eating well and gaining weight.

How long is the stay in the hospital?
You will need to stay in the hospital for 10-14 days. You may spend 1-3 nights in the intensive care unit depending on how well you recover.

How long before I will be eating solid foods?
For the first week after surgery you will be drinking liquids only. In the second week you will start to eat soft foods. By 2 months you can eat a normal diet.

How long before I am back to my normal levels of exercise?
It is recommended that you refrain from strenuous activities and heavy lifting for about 2 months.

When will I be back to my normal routine?
Usually by 2 months you can return to your normal routine.

What follow up is necessary?
A follow up visit 2 weeks after surgery is necessary.