Esophageal Cancer Surgery in Uberlândia-MG

The most characteristic symptom is progressive dysphagia — difficulty swallowing that begins with solid foods and progresses to liquids. Unintentional weight loss, odynophagia (pain when swallowing), persistent hoarseness, chronic cough, frequent choking, and gastrointestinal bleeding (evidenced by anemia or darkened stools) may also occur. Since symptoms tend to appear in more advanced stages, chronic reflux or persistent dysphagia warrant prompt medical evaluation.

The diagnosis is confirmed by upper gastrointestinal endoscopy with biopsy of the lesion, which determines the histological subtype (adenocarcinoma or squamous cell carcinoma). For staging, endoscopic ultrasound is used (to assess the depth of invasion into the esophageal wall), along with computed tomography of the chest and abdomen and, when indicated, PET-CT, to screen for regional lymph node involvement and distant metastases. Together, these exams guide the multidisciplinary team's therapeutic strategy.

Esophagectomy is a highly complex procedure, with an average duration of 5 to 8 hours, which may vary depending on the surgical approach (transthoracic, transhiatal, or minimally invasive/robotic), the extent of resection, the need for lymphadenectomy, and each patient's anatomical characteristics. The exact surgical time is discussed individually during preoperative planning.

The procedure is performed under general anesthesia, often combined with regional analgesia techniques (such as thoracic epidural block) to optimize postoperative pain control. Preoperative anesthetic assessment includes cardiopulmonary exams, since the surgery typically involves thoracic access and requires careful respiratory monitoring during and after the procedure.

Hospital stay after esophagectomy typically ranges from 7 to 14 days, including an initial period in the intensive care unit for respiratory and hemodynamic monitoring. The exact duration depends on the surgical approach used, the progress of anastomotic healing, and any complications that may arise, and is reassessed daily by the care team.

Pain control typically combines thoracic epidural analgesia, intravenous analgesics, and, later, oral medication, following an individualized protocol. Pain tends to be more intense in the first few days, especially when thoracic access is involved, and progressively decreases with healing. The pain management team monitors the patient daily to adjust the regimen according to clinical response.

Yes. It is common to use a chest tube (when thoracic access is involved), a nasoenteral tube or jejunostomy for early feeding while the anastomosis heals, and sometimes a temporary nasogastric tube. These devices are progressively removed as exams confirm the integrity of the digestive tract reconstruction and clinical progress allows reintroduction of an oral diet.

The scarring pattern depends on the surgical approach: in open surgery, there are abdominal and/or thoracic incisions (and cervical, if necessary); in minimally invasive techniques (laparoscopy, thoracoscopy, or robotic surgery), the incisions are smaller and fewer in number. The extent and location of scars are discussed beforehand, according to the technique indicated for each case.

Time off work typically ranges from 4 to 8 weeks for light activities, and may extend longer for roles requiring more intense physical effort. This period depends on the surgical approach used, the recovery of respiratory and nutritional capacity, and any need for additional oncologic treatment, and is determined individually throughout postoperative follow-up.

As a major surgical procedure, esophagectomy carries risks such as anastomotic leak, pulmonary complications (pneumonia, pleural effusion), infection, bleeding, and swallowing difficulties. Patients with severe cardiopulmonary comorbidities or low functional reserve may have relative contraindications to the procedure. Each case is evaluated individually, and specific risks are discussed in detail during the preoperative consultation.

Not necessarily — it depends on the tumor stage. In locally advanced cases, neoadjuvant chemotherapy or chemoradiotherapy typically precedes esophagectomy to reduce tumor size, and adjuvant therapy may be indicated based on the pathology results. This decision is made by a multidisciplinary team — oncologic surgery, clinical oncology, radiation oncology, and nutrition — according to each patient's individual characteristics.