Esophagectomy Intervention ICD-9-CM 42.40 MeSH
Esophagectomy or Oesophagectomy (regional variation in spelling) is the surgical removal of all or part of the esophagus (also spelled 'oesophagus').
The principal objective is to remove the esophagus, a part of the gastrointestinal tract ("food pipe"). This procedure is usually done for patients with esophageal cancer. It is normally done to remove cancerous tumors from the body. It is best done when an esophageal cancer is detected early, before it has spread. If taken up early enough, an esophagectomy might prove to be life saving. Despite significant improvements in technique and postoperative care, the long term survival for esophageal cancer is still poor. Currently multimodality treatment is needed (chemotherapy and radiation therapy) for advanced tumors. Esophagectomy is also occasionally performed for benign disease such as esophageal atresia in children, achalasia, or caustic injury.
There are two main types of esophagectomy.
- A trans-thoracic esophagectomy (TTE) involves opening the thorax (chest).
In most cases, the stomach is transplanted into the neck and the stomach takes the place originally occupied by the esophagus. In some cases, the removed esophagus is replaced by another hollow structure, such as the patient's colon.
Another option which is slowly becoming available is minimally invasive surgery (MIS) which is performed laparoscopically and thoracoscopically.
After surgery, patients may have trouble with a regular diet and may have to consume softer foods, avoid liquids at meals, and stay upright for 1–3 hours after eating. Dysphagia is common and patients are encouraged to chew foods very well or grind their food. Patients may complain of substernal pain that resolves by sipping fluids or regurgitating food. Reflux-type symptoms can be severe, including intolerance to acidic foods and large, fatty meals. Jejunal feeding tubes may be placed during surgery to provide a temporary route of nutrition until oral eating resumes.
Esophagectomy is a very complex operation that can take between 4 and 8 hours to perform. It is best done exclusively by doctors who specialise in upper gastrointestinal surgery. Anesthesia for an esophagectomy is also complex, owing to the problems with managing the patient's airway and lung function during the operation. Lung collapse is highly probable as well as losing function of diaphragm and possible injury of the spleen.
Average mortality rates (deaths either in hospital or within 30 days of surgery) for the operation are around 10% in US hospitals. However recognized major cancer hospitals typically report mortality rates under 5%.
Major complications occur in 10-20% of patients, and some sort of complication (major and minor) occurs in 40%. Time in hospital is usually 1–2 weeks and recovery time 3–6 months. It is possible for the recovery time to take up to a year.
Digestive system surgical and other procedures / Digestive system surgery (ICD-9-CM V3 42-54, ICD-10-PCS 0D) Digestive tractUpper GI tractTransrectal ultrasonography · Abdominal ultrasonography · Enteroclysis · Small bowel follow-through · Lower gastrointestinal series · Virtual colonoscopy · Defecating proctogram · Double-contrast barium enema Accessory AbdominopelvicHernia repair: Inguinal hernia repair (Macewen's operation) · Femoral hernia repair Other CPRs Surgery: surgical procedures (including Ectomy, stomy, and otomy) EctomyGenitalMusculoskeletalcns (Decompressive craniectomy, Hemispherectomy, Anterior temporal lobectomy, Hypophysectomy, Amygdalohippocampectomy, Laminectomy, Corpectomy, Facetectomy) · pns (Ganglionectomy, Sympathectomy/Endoscopic thoracic sympathectomy, Neurectomy) · ear (Stapedectomy, Mastoidectomy) · eye (Photorefractive keratectomy, Trabeculectomy, Iridectomy, Vitrectomy)GastrointestinalRespiratoryEndocrineRenalLymphaticUngrouped StomyGastrointestinalUrogenitalNervous system OtomyUrogenitalNervous systemMusculoskeletalGastrointestinalRespiratoryCardiovascularCardiotomy · PhlebotomyUngrouped
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См. также в других словарях:
esophagectomy — noun The surgical procedure for the removal of all, or part of the esophagus … Wiktionary
Esophagectomy — An operation to remove a portion of the esophagus. * * * Excision of all or any part of the esophagus. [esophagus + G. ektome, excision] Ivor Lewis e. commonly used approach for e. via laparotomy and right thoracotomy, with intrathoracic … Medical dictionary
esophagectomy — /əsɒfəˈdʒɛktəmi/ (say uhsofuh jektuhmee) noun (plural esophagectomies) → oesophagectomy … Australian English dictionary
esophagectomy — An operation to remove a portion of the esophagus … English dictionary of cancer terms
Ivor Lewis esophagectomy — Ivor Lew·is esophagectomy (iґvor looґis) [Ivor Lewis, Welsh surgeon, 1895â€“1982] transthoracic esophagectomy … Medical dictionary
Ivor Lewis esophagectomy — transthoracic e … Medical dictionary
transhiatal esophagectomy — removal of the thoracic part of the esophagus by blunt dissection superiorly through a cervical incision and inferiorly with a transhiatal approach through an abdominal incision … Medical dictionary
transthoracic esophagectomy — removal of part or all of the thoracic part of the esophagus through abdominal and right thoracotomy incisions; called also Ivor Lewis e … Medical dictionary
List of surgical procedures — Surgical procedures have long and possibly daunting names. The meaning of many surgical procedure names can often be understood if the name is broken into parts. For example in splenectomy, ectomy is a suffix meaning the removal of a part of the… … Wikipedia
Esophageal cancer — Classification and external resources Endoscopic image of patient with esophageal adenocarcinoma seen at gastro esophageal junction. ICD 10 C … Wikipedia