How is surgery done for oesophagus cancer?

This is major surgery and should be done by surgeons skilled and experienced in managing patients with these cancers. This surgery is usually only performed with ‘curative intent’ such that the goal is to remove the whole visible cancer along with a margin of adjacent normal tissue along with lymph nodes (glands that drain fluid from where the cancer has been). It is often done after some chemotherapy +/- radiotherapy to improve the prognosis. The location of the cancer and the lymph nodes are identified allowing the surgical approach to be determined and how much oesophagus (and portion of stomach) needs to be removed. This may include an abdomen only approach (if near the junction of oesophagus and stomach) or both abdomen and chest approach (between the ribs for oesophageal cancer). The cancer is removed and the continuity of the gastro-intestinal tract is reconstructed, then all the surgery incisions are stitched closed. Laparoscopy/thoracoscopy or keyhole surgery is used when appropriate and safe to do so, otherwise open surgery is used to ensure the best change of complete cancer removal.