Cookies on the Bupa website

We use cookies to help us understand ease of use and relevance of content. This ensures that we can give you the best experience on our website. If you continue, we'll assume that you are happy to receive cookies for this purpose. Find out more about cookies

Continue

Navigation

Removal of part of the oesophagus and stomach (oesophagogastrectomy)

An oesophagogastrectomy is surgery to remove the upper part of the stomach and the lower part of the oesophagus. This is the pipe that goes from your mouth to your stomach.

You will meet the surgeon carrying out your procedure to discuss your care. It may be different from we’ve described here as it will be designed to meet your individual needs.

You may need to have an oesophagogastrectomy if you have cancer at the junction between your stomach and oesophagus.

An oesophagogastrectomy involves having the lower part of your oesophagus and the upper part of your stomach removed. The amount you have removed depends on many things, such as the type of tumour you have and where it is. The remaining part of your oesophagus is then joined to the remaining part of your stomach.

It’s important to remember that the treatments you’re offered may be different depending on your personal circumstances. Your doctor will discuss your treatment options with you to help you make a decision that’s right for you. Your decision will be based on your doctor’s expert opinion and your own personal values and preferences.

Read more Close
An image showing removal of part of the oesophagus and stomach

Details

  • Preparation Preparing for an oesophagogastrectomy

    Depending on what type of cancer you have, you may be given a course of chemotherapy or radiotherapy before your operation. Your doctor will have a chat with you about your treatment options once your diagnosis has been confirmed.

    Your surgeon will explain how to prepare for your procedure. For example, if you smoke, you will be asked to stop. Smoking can increase your risk of getting a chest and wound infection, which can slow your recovery.

    Before you have an oesophagogastrectomy, your doctor will need to do some tests. These are to make sure the procedure is right for you.

    • Endoscopy. This procedure is used to look inside your oesophagus, stomach and the first part of your small bowel (duodenum) using an endoscope. An endoscope is a narrow, flexible, tube-like camera. It allows a biopsy to be taken. A biopsy is a small sample of tissue. This will be sent to a laboratory for testing to determine the type of cells and if these are benign (not cancerous) or cancerous.
    • Barium swallow and meal. This involves swallowing a drink that contains barium (a substance which shows up on X-rays). X-ray images of the upper abdomen (tummy) then show the inside of your oesophagus and stomach more clearly.
    • CT or MRI scan. A CT scan uses X-rays to make a three-dimensional image of your body. An MRI scan uses magnets and radio waves to produce images of the inside of your body. They are used to find out the size of your tumour and if the cancer has spread.

    To make sure you’re well enough to have an oesophagogastrectomy, your doctor may recommend some further tests. Some of these are listed below.

    • Blood tests, chest X-ray and a cardiopulmonary exercise test. A cardiopulmonary exercise test involves running on a treadmill to see how well your heart and lungs work.
    • An electrocardiogram. This is a test that records the rhythm and electrical activity of your heart. Your doctor may also ask you to have an echocardiogram, which involves using ultrasound to produce moving images of your heart).

    An oesophagogastrectomy is performed under general anaesthesia. This means you will be asleep during the procedure. An anaesthetic can make you sick, so it’s important you don’t eat or drink anything for six hours beforehand. Follow your surgeon’s advice and if you have any questions, just ask.

    Your surgeon will discuss with you what will happen before, during and after your procedure, and any pain you might have. This is your opportunity to understand what will happen. You can help yourself by preparing questions to ask about the risks, benefits and any alternatives to the procedure. This will help you to be informed, as you will be asked to sign a consent form for the procedure to go ahead.

    You may be asked to wear compression stockings to help prevent blood clots forming in the veins in your legs. As well as wearing compression stockings, you may also be given an injection of an anti-clotting medicine such as heparin or tinzaparin.

  • The procedure What happens during an oesophagogastrectomy?

    The length of your procedure can vary depending on which type of operation you have.

    An oesophagogastrectomy can be done using either open or keyhole surgery. In an open procedure, your surgeon will make two large cuts into your upper abdomen (tummy) and chest. For a keyhole procedure, your surgeon will make several small cuts instead. The operation is done using special instruments, and viewed through a camera inserted into one of the cuts. Talk to your surgeon about which procedure is most suitable for you.

    During the operation, your surgeon will remove the diseased part of your oesophagus and stomach. They will then rejoin the remaining part of your oesophagus to the healthy part of your stomach.

    Sometimes your surgeon may attach your oesophagus to your small bowel if your entire stomach needs to be removed. They will also remove nearby lymph nodes to check for cancer cells. This will help to find out if you need any further treatment.

    Your surgeon may insert a feeding tube into your small bowel, which is brought to the surface of your skin. This is called a jejunostomy. After your surgery, you’ll be able to have food in the form of liquid through this tube.

  • Aftercare What to expect afterwards

    After having an oesophagogastrectomy, you’ll be transferred to the intensive care or high dependency ward at first. You might have some discomfort as the anaesthetic wears off. But you'll be offered pain relief as you need it. You may also be offered patient controlled analgesia. This is a pump connected to a drip in your arm that allows you to control how much pain medicine you have.

    You may have a catheter (tube) to drain urine from your bladder into a bag. You may also have fine tubes running out from the wound. These drain fluid into another bag while your wound heals.

    You will have a drip inserted into a vein in your hand or arm, or into the side of your neck to give you fluids. When you feel well enough, you can start to drink small amounts of water.

    When you wake up after the surgery, you’re likely to have a fine tube in one nostril (this is called a nasogastric tube). This will go across the area where your oesophagus and stomach have been joined. You will be encouraged to get out of bed when you feel ready, usually with the help of a physiotherapist. Moving around after your operation can help prevent complications and may help to speed up your recovery. You will also have daily injections to help prevent blood clots.

    You will usually be able to go home four to eight days after your operation. Make sure someone can take you home. And ask someone to stay with you for a day or so while the anaesthetic wears off.

    Before you go home, you will see your surgeon so you can discuss how the procedure went and any further treatment you might need. Your nurse will advise you about caring for your healing wounds and may arrange a date for a follow-up appointment.

  • Bupa On Demand

    You don’t have to be a Bupa member to access a range of our health and wellbeing services thanks to Bupa On Demand. Find out more today.

  • Recovery Recovering from oesophagogastrectomy

    The amount of time it takes to make a full recovery from an oesophagogastrectomy varies from person to person. It’s important to follow your surgeon’s advice. If you had a keyhole procedure, your recovery may be slightly faster.

    If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.

    You’ll need to make some changes to your diet after your procedure. For example, you’ll only be able to eat small amounts of food at each meal. Before you go home, you’ll be given advice on how to eat well while you recover. To begin with, you’ll need to eat foods that are very soft. Your dietitian or surgeon will explain how to start eating solid foods again. You may also be asked to take vitamin and mineral supplements to help your recovery.

  • Risks What are the risks?

    As with every procedure there are some risks associated with oesophagogastrectomy. We have not included the chance of these happening as they are specific to you and differ for every person. Ask your surgeon to explain how these risks apply to you.

    Side-effects

    Side-effects are the unwanted but mostly temporary effects you may get after having the procedure. For example, you may feel sick as a result of the general anaesthetic.

    You may have some pain after your procedure. You may also have a dry cough and diarrhoea for the first few months afterwards.

    Depending on what type of operation you had, you may have a scar on your chest, abdomen (tummy) or neck. Although your scar may be slightly raised and swollen at first, this should gradually settle over time.

    Complications

    Complications are when problems occur during or after the procedure. Complications of oesophagogastrectomy can include the following.

    • Leakage. This is the most serious complication. If the join leaks, you may need further surgery.
    • An infection called mediastinitis, which can cause severe chest pains and fever. This can happen if there’s a tear in your oesophagus. Mediastinitis can be treated with antibiotics or further surgery.
    • Narrowing of the new join. The join may need gentle stretching to reopen it using an endoscope (a flexible tube-like camera).
    • Heartburn (acid reflux). An oesophagogastrectomy involves removing the valve at the lower end of your oesophagus. This means you will no longer have a barrier to stop the acidic contents of your stomach pushing up into your oesophagus. When this happens, it causes a burning sensation in your chest (known as heartburn). You can help prevent this by sleeping propped up and not eating late in the evening.
  • FAQs FAQs

    Will I need to change my diet after I’ve had an oesophagogastrectomy?

    Answer

    Yes, you may need to change your diet as some foods can cause problems with your digestive system. It’s worth bearing in mind that it may take a few months for your stomach to get back to normal. You will usually be seen by a dietitian after your procedure who will give you advice about how to eat well while you recover.

    Explanation

    For the first two or three weeks after your procedure, you’ll need to eat food that is very soft. This will help the new join between your stomach and oesophagus heal. You may be given advice about what to eat by a dietitian. For example, you may be advised to follow a diet that’s high in protein and take vitamin supplements to help your recovery.

    Then, in the following few months, you’ll be able to eat small portions regularly throughout the day, rather than one big meal. Small portions will be easier for your stomach to manage and will reduce your risk of heartburn (acid reflux).

    Talk to your surgeon or dietitian for more information about the foods you can eat after your procedure.

    How soon can I do physical activity after I’ve had an oesophagogastrectomy?

    Answer

    Recovering from an oesophagogastrectomy can take some time. You will need to take things slowly for the first few weeks and build up the amount of physical activity you do gradually.

    Explanation

    Oesophagogastrectomy is a major operation and you will need to take it easy for a while. Following your procedure, you will need to rest in bed. On the second or third day, you’ll be encouraged to get up and sit in a chair. Over the next few days your physiotherapist will show you some exercises to do. It’s important to do these exercises as they will help your recovery and improve your strength.

    At home as you recover, you can begin to do some walking. Start by walking just around the house and then gradually increase the distance. But it’s important not to push yourself.

    Don’t do any activities that involve holding your breath, such as heavy lifting, for at least six weeks after your operation.

    When can I return to work after I’ve had an oesophagogastrectomy?

    Answer

    The exact amount of time you will need to have off work will be specific to you. This is because it not only depends on your recovery from the procedure, but also on the type of work you do.

    Explanation

    The amount of time you will need to take off work will depend on a number of different factors. These include your age, the type of work you do and how well you recover after the procedure. Other factors include your general health and whether you’re having any further treatment, such as chemotherapy or radiotherapy.

    You’re likely to be off work for several months and you shouldn’t go back until your surgeon or doctor tells you it’s safe to do so. When you do return, you may find you get tired easily, so it’s important to take regular breaks. It’s important to let your employer know about your treatment, as you may need to arrange some time off for further treatments or check-ups.

  • Resources Resources

    Further information

    Sources

    • Gastric cancer. Medscape. www.emedicine.medscape.com, published June 2014
    • Surgery to remove oesophageal cancer. Cancer Research UK. www.cancerresearchuk.org, reviewed April 2014
    • Management of oesophageal and gastric cancer. Scottish Intercollegiate Guidelines Network (SIGN), 2006. www.sign.ac.uk
    • Surgery for oesophageal cancer. Macmillan Cancer Support. www.macmillan.org.uk, reviewed July 2012
    • A guide to life after oesophageal/gastric surgery. Oesophageal Patients Association. www.opa.org.uk, published September 2013
    • Map of Medicine. Upper gastrointestinal (GI) cancer. International View. London: Map of Medicine; 2014 (Issue 1).
    • Allum WH, Griffin SM, Watson A, et al. Guidelines for the management of oesophageal and gastric cancer. Gut 2002;50:v1−v23. doi:10.1136/gut.50.suppl_5.v1
    • Oesophageal cancer: diagnosis. British Society of Gastroenterology. www.bsg.org.uk, accessed 10 October 2014
    • Understanding upper endoscopy. American Society for Gastrointestinal Endoscopy. www.asge.org, accessed 10 October 2014
    • You and your anaesthetic. Royal College of Anaesthetists. www.rcoa.ac.uk, published August 2014
    • Having your oesophageal cancer operation. Cancer Research UK. www.cancerresearchuk.org, reviewed April 2014
    • Prevention of venous thromboembolism. PatientPlus. www.patient.co.uk/patientplus.asp, published June 2014
    • Venous thromboembolic diseases. National Institute for Health and Care Excellence (NICE), 2012. www.nice.org.uk
    • Oesophageal cancer: treatment. British Society of Gastroenterology. www.bsg.org.uk, accessed 10 October 2014
    • After your operation. Macmillan Cancer Support. www.macmillan.org.uk, reviewed August 2013
    • Diet and oesophageal cancer. Cancer Research UK. www.cancerresearchuk.org, reviewed April 2014
    • Risks and side effects of esophagectomy. American Cancer Society. www.cancer.org, published April 2014
    • Stomach Cancer. BMJ Best Practice. www.bestpractice.bmj.com, published September 2013 
    • Oesophageal cancer. PatientPlus. www.patient.co.uk/patientplus.asp, published 19 January 2012
    • Oesophageal cancer. BMJ Best Practice. www.bestpractice.bmj.com, published 18 December 2013
    • Perioperative anaesthetic care and practical procedures. Theatre procedures and prophylaxis. Upper gastrointestinal surgery. OSH Operative surgery (online). Oxford Medicine Online. www.oxfordmedicine.com, published October 2011
    • Cardiology and vascular disease. Oxford handbook of general practice (online). Oxford Medicine Online. www.oxfordmedicine.com, published April 2014
    • Enteral feeding. PatientPlus. www.patient.co.uk/patientplus.asp, published 18 March 2011
    • What to expect after the operation. Royal College of Surgeons. www.rcseng.ac.uk, accessed 5 November 2014
    • Complications of gastrointestinal surgery. Oxford handbook of post operative complications (online). Oxford Medicine Online. www.oxfordmedicine.com, published October 2011
    • Nursing care of patients having oesophageal and gastric surgery. Oxford handbook of adult nursing (online). Oxford Medicine Online. www.oxfordmedicine.com, published August 2010
    • Mediastinitis. The Merck Manuals. www.merckmanuals.com, published 20 September 2014
    • Mediastinitis. Medscape. www.emedicine.medscape.com, published 5 December 2013
    • Post-operative pain. OSH Post operative complications (online). Oxford Medicine Online. www.oxfordmedicine.com, published October 2011
  • Has our information helped you? Tell us what you think about this page

    We’d love to know what you think about what you’ve just been reading and looking at – we’ll use it to improve our information. If you’d like to give us some feedback, our short form below will take just a few minutes to complete. And if there's a question you want to ask that hasn't been answered here, please submit it to us. Although we can't respond to specific questions directly, we’ll aim to include the answer to it when we next review this topic.

    Let us know what you think using our short feedback form
    Ask us a question
  • Related information Related information

  • Author information Author information

    Reviewed by Hemali Bedi, Bupa Health Information Team, December 2014.

About our health information

At Bupa we produce a wealth of free health information for you and your family. We believe that trustworthy information is essential in helping you make better decisions about your health and care. Here are just a few of the ways in which our core editorial principles have been recognised.

  • Information Standard

    We are certified by the Information Standard. This quality mark identifies reliable, trustworthy producers and sources of health information.
    Information standard logo
  • HONcode

    This site complies with the HONcode standard for trustworthy health information: verify here.

    This website is certified by Health On the Net Foundation. Click to verify.

What our readers say about us

But don't just take our word for it; here's some feedback from our readers.

Simple and easy to use website - not alarming, just helpful.

It’s informative but not too detailed. I like that it’s factual and realistic about the conditions and the procedures involved. It’s also easy to navigate to areas that you specifically want without having to read all the information.

Good information, easy to find, trustworthy.

Meet the team

Image of Andrew Byron

Andrew Byron
Head of health content and clinical engagement




  • Dylan Merkett – Lead Editor – UK Customer
  • Nick Ridgman – Lead Editor – UK Health and Care Services
  • Natalie Heaton – Specialist Editor – User Experience
  • Pippa Coulter – Specialist Editor – Content Library
  • Alice Rossiter – Specialist Editor – Insights
  • Laura Blanks – Specialist Editor – Quality
  • Michelle Harrison – Editorial Assistant

Our core principles

All our health content is produced in line with our core editorial principles – readable, reliable, relevant – which are represented by our diagram.

An image showing or editorial principals

                  Click to open full-size image

The ‘3Rs’ encompass everything we believe good health information should be. From tweets to in-depth reports, videos to quizzes, every piece of content we produce has these as its foundation.

Readable

In a nutshell, our information is jargon-free, concise and accessible. We know our audience and we meet their health information needs, helping them to take the next step in their health and wellbeing journey.

Reliable

We use the best quality and most up-to-date evidence to produce our information. Our process is transparent and validated by experts – both our users and medical specialists.

Relevant

We know that our users want the right information at the right time, in the way that suits them. So we review our content at least every three years to keep it fresh. And we’re embracing new technology and social media so they can get it whenever and wherever they choose.

Our accreditation

Here are just a few of the ways in which the quality of our information has been recognised.

  • The Information Standard certification scheme

    You will see the Information Standard quality mark on our content. This is a certification programme, supported by NHS England, that was developed to ensure that public-facing health and care information is created to a set of best practice principles.

    It uses only recognised evidence sources and presents the information in a clear and balanced way. The Information Standard quality mark is a quick and easy way for you to identify reliable and trustworthy producers and sources of information.

    Certified by the Information Standard as a quality provider of health and social care information. Bupa shall hold responsibility for the accuracy of the information they publish and neither the Scheme Operator nor the Scheme Owner shall have any responsibility whatsoever for costs, losses or direct or indirect damages or costs arising from inaccuracy of information or omissions in information published on the website on behalf of Bupa.

  • British Medical Association (BMA) patient information awards

    We have received a number of BMA awards for different assets over the years. Most recently, in 2013, we received a 'commended' award for our online shared decision making hub.

Contact us

If you have any feedback on our health information, we would love to hear from you. Please contact us via email: healthinfo@bupa.com. Or you can write to us:

Health Content Team
Bupa House
15-19 Bloomsbury Way
London
WC1A 2BA

Find out more Close

Legal disclaimer

This information was published by Bupa's Health Content Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition.

The information contained on this page and in any third party websites referred to on this page is not intended nor implied to be a substitute for professional medical advice nor is it intended to be for medical diagnosis or treatment. Third party websites are not owned or controlled by Bupa and any individual may be able to access and post messages on them. Bupa is not responsible for the content or availability of these third party websites. We do not accept advertising on this page.

For more details on how we produce our content and its sources, visit the 'About our health information' section.

ˆ We may record or monitor our calls.