Esophagectomy Surgery Guide

Incisions

• If you have an open esophagectomy, you will have 2 or 3 of these incisions (cuts):
  • An incision on your side (thoracotomy).
  • An incision down the middle of your abdomen (laparotomy).
  • An incision on the side of your neck.
• ​If you have an MIE, you will have 5 small incisions on your abdomen. The size of your incisions depends on the way your surgeon decided to do your operation.​

Stitches or staples: ​

• Your surgeon usually uses dissolvable stitches to close your incisions. This means they go away on their own. If they are not dissolvable, your nurse usually removes the stitches or staples 7 to 10 days after your surgery.
• If your stitches or staples need to remain in after you are discharged home, your family doctor can remove them. We will tell you if this is the case and give you a staple remover to take to your family doctor.​

Dressings (bandages)

• ​You will have dressings covering your incisions. The first dressing is changed the day after your surgery. Then, they are changed at least once a day.​

Chest Tubes:

• You will have 1 to 2 chest tubes coming out of the side of your chest. These tubes remove air and fluid from the inside of your chest area. The tubes are attached to a machine that helps suck the air and fluid out.
• We use stitches to keep the chest tubes in place. These are not dissolvable. We remove your chest tubes once it is safe. We remove the stitches 7 to 10 days after we take the tubes out.​

J-tube (Jejunostomy feeding tube)

• ​You may have a small tube placed through your abdomen and into your small intestine during your surgery. It is called a J-tube, and it is used to give you liquid food and medicines until you are able to drink and eat well.
• You will go home with the J-tube still in.
• Your surgeon or nurse practitioner will let you know when it is safe to remove your tube. It will be removed in the outpatient clinic.​

NG tube (nasogastric tube)

• You will have a small tube called an NG tube coming out of your nose. It was put in during your surgery. It drains fluid, bile (stomach acid) and air from your stomach to help prevent nausea and vomiting.​

JP drain (Jackson Pratt drain)​

• You will have a small tube called a JP drain that helps drain any extra fluid. It is removed when you no longer need it.​

Heart monitor:

• You will be on a heart monitor while you are in the Step-Down Unit. This does not mean there is a problem with your heart. We do this for all patients who have your type of surgery.​

Urinary catheter:

• You will have a tube draining your bladder. You have this tube for 1 to 2 days. While you are in the hospital, the nurse measures how much you urinate.​

Intravenous (IV):

• You have an IV so we can give you fluids and medicines. It stays in until you are drinking well. In about 5 to 7 days, you may have a barium swallow test. This test will let your surgeon know if it is safe for you to drink fluids by mouth.​

Arterial line:

• This tube looks like an IV, and we use it to take blood samples without having to poke you with a needle. It also closely monitors your blood pressure.​

Oxygen:

• You may need oxygen after your operation. You get the oxygen either by facemask or through your nostrils (nasal prongs). We remove the oxygen once your lungs are working well enough.​

Epidural.

• With an epidural, a doctor puts a small tube in your back. They usually do this right before your surgery. The tube is left in place to give you pain medicine after your surgery. It is attached to a pump, which gives you the medicines. They include a pain killer and medicine that numbs the area where you had surgery. They may make your legs feel numb or heavy.​

Intravenous (IV) Patient Controlled Analgesic or PCA

• A PCA pump is connected to your IV. The pump gives you pain medicine through your IV when you push the button.
• You should press the button:
  • When you start to feel pain
  • Before you do something that brings on pain
  • Before you do deep breathing and coughing exercises
  • Before you start to move or turn you should feel the effects of the medicine within 2 to 3 minutes.
• ​If yo​u don't feel any pain relief, let your nurse know. You are only allowed to have a certain amount of pain medicine every 4 hours. To control how much medicine you get, the PCA pump has a safety timer called a lock out. If you press the button during the lockout time, you won't get more medicine. Only you should press the button.
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Intravenous (IV) medicine.

• You get your pain medicine through an IV. It's important to let your nurse know when you have pain so they can give you the pain medicine. If you don't feel any pain relief after getting the medicine, let your nurse know.​

J-tube (Jejunostomy feeding tube)

• ​You may get your pain medicine through your J-tube. Let your nurse know when you have pain, and they can give you pain medicine.

Medicine by mouth

• ​You may get your pain medicine in tablets that you swallow. This will happen once you are drinking fluids. Let your nurse know when you have pain, so they can give you the pain medicine.​

Depending on your surgery, you will stay in the hospital from 7 to 10 days. When you can go home will depend on how you are recovering. Your health care team may tell you during their morning rounds (check-ins) that you can go home that day. Before coming to the hospital, plan to have someone pick you up when you are ready to go home after your operation.​