Most of the time, surgical treatment involves removal of the tumor with a portion of the esophagus. There are several types of incisions that may be used and, usually, the stomach is used to reconnect the upper esophagus to the rest of the gastrointestinal tract. Surgeons choose the type of incision and reconstruction based on what will offer the patient the best chance for cure. Often, patients with esophageal cancer have a poor nutritional status and other medical problems that may limit the procedure that they will be able to tolerate. All of these factors are taken into consideration when decisions about surgical procedures are made by doctors and their patients.
Recovery varies with the overall fitness of the patient and is difficult to predict precisely.
However, a minimum of 10-14 days in the hospital should be expected. Patients typically have tubes placed into their small intestine with which tube feedings can be given postoperatively before oral intake is resumed. In addition, nothing will be permitted by mouth until after an x-ray study is performed to be certain that the anastomosis is intact and water tight. A substantial amount of pain is present in the immediate postoperative period and is controlled with narcotic analgesics in most cases. Early mobilization is critical to an optimal recovery and patients are pushed to ambulate and sit upright as much as possible starting 24-48 hours after surgery.