Esophagectomy

Posted , 4 users are following.

Hi! Where to start....I've head 2 Nissen fundoplication surgeries in the last 6 years. I've been diagnosed with Barretts as well. My surgeon is concerned about the length of the Barretts and wants to do an esophagectomy. I've been reading up on it and to be honest...I'm scared. I have 2 more tests before surgery...a gastric emptying study and a final endoscopy. Any words or advice or questions to ask the surgeon?

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  • Posted

    Breezy,

    I strongly suggest that you get a 2nd opinion before agreeing to an esophagectomy. I think that most doctors would recommend an ablation treatment instead of an esophagectomy. About 18 months ago I was diagnosed with stage 1 esophageal cancer. Even then, my doctor said that he usually recommends an ablation treatment for stage 1a cancers and an esophagectomy for stage 1b cancers. Mine was stage 1b so I had the surgery.

    Although I was 60 years old at the time of my surgery, I was in good health and had no chronic issues other than arthritis and reflux issues, which had actually been relieved with a Nissan's procedure 9 years previous. My surgery went well and I was able to leave the hospital after 8 days. I didn't need to use the feeding tube once I got home. (I think I was the exception and not the rule on that.) Even as well as I did, it was a dangerous and unpleasant experience. I ended up having two more surgeries because of some connective tissue issues that prevented my internal incisions from staying together as they should have. I also became seriously anemic and required 9 iron transfusions to overcome that. I lost 40 pounds, which was ok in my case because I had them to lose. If you don't have them to lose it may not be as ok for you.

    If you decide to agree to the surgery, check out the experience of the doctor and the hospital. Research shows that the number of esophagectomies performed in a hospital is just as important as the number performed by the surgeon when it comes to the death rate from the surgery. I was lucky to have a top-rated surgeon and a hospital with a floor dedicated to this surgeon's patients, so all of the staff were very familiar with the needed therapies.

    It seems from this discussion that people in the US are a little more free to choose doctors and hospitals than those in the UK. I don't know where you are, but do whatever research you can do into your caretakers.

    I wish you all the best.

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  • Posted

    Hi, I don't no what a Nissan op is, but I had stage 1 cancer of the oesophagus, I was told if I didn't have the full op then the cancer would come back and they didn't know at what stage or quickness of its return, it wasn't a pleasant op and the nearly 7 years since hasn't been a breeze, but I'm still alive! Reading through Becky's comment, well that would scare the hell out of me tbh. I've never pretended to anyone that it's all rosy because it's not, my life was turned upside down, you just got to look on the bright side, a piece of advice I was given, by my surgeon was to put on as much weight as poss before the op because you lose a lot, all I can say is weigh up all the options and choose what's best for you, try to keep a positive outlook and grasp your opportunities. Good luck my lovely, always here if you want to chat xx

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  • Posted

    Generally, whether Barrett's oesophagus is a risk or not depends on whether there is high grade dysplasia or not, something that can only be determined after an endoscopy and biopsies. If you have high grade dysplasia you have a moderate risk of developing cancer and most specialists would recommend treatment. Radio frequency ablation can be used to treat the Barrett's without resorting to an oesophagectomy in many cases. The length of the Barrett's segment is a risk factor but not normally sufficient in itself to justify an oesophagectomy. There is more on the website of Action Against Heartburn.

    This is a very specialised area of medicine and you need to be seen by a specialist Upper GI centre.

    So I think there are two questions. Do you suffer from high grade dysplasia? Why has the previous fundoplication surgery not stopped the damage being caused by the reflux?

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