Esophageal Cancer Surgery in Ankara, Turkey

Esophageal cancer surgery is a surgical procedure performed to remove tumor tissue in the esophagus. In early stages, only the tumor-containing area is removed, while in advanced cases, the entire esophagus may be removed. This operation increases life expectancy and comfort.

In esophageal cancer surgery, laparoscopic and open techniques can be used. The method to be chosen is determined by considering the size and location of the tumor and the patient’s overall health condition. Surgery is often accompanied by chemotherapy and radiotherapy.

Nutrition is of great importance in the post-operative period. Patients start with liquid foods and gradually transition to normal nutrition. With early mobilization and breathing exercises, the risk of complications is reduced and recovery is accelerated.

Regular follow-up after esophageal cancer surgery enables early detection of recurrence and metastasis. With a multidisciplinary approach, surgical, oncologic, and nutritional support are carried out together to increase treatment success.

You can contact Prof. Dr. Ebru Soy, one of the doctors performing Esophageal Cancer Surgery in Ankara, to get information about Esophageal Cancer Surgery prices, the process, and the hospital where Esophageal Cancer Surgery is performed.

What Is Esophageal Cancer?

Esophageal cancer is a malignant tumor that develops in the cells lining the inner surface of the esophagus. There are two main types: squamous cell carcinoma and adenocarcinoma. It usually causes symptoms in advanced stages.

What Is Esophageal Cancer Surgery?

We can think of this surgery as a journey consisting of two main parts. The first and most important goal of the journey is to completely remove the cancerous tissue from the body. At this stage, the surgeon removes the tumor-containing part of the esophagus together with a margin of healthy tissue around it. The lymph nodes, which are the closest stations with the potential for cancer cells to spread, are also meticulously removed at the same time. Removing the lymph nodes allows us to understand the true stage of the disease and helps us plan the next steps of treatment. This is not only a clearance procedure but also a critical step that maps the disease.

The second part of the journey is the reconstruction phase. After the esophagus is removed, a new pathway must be created for swallowed food to reach the stomach. For this, the most commonly used and most natural method is to shape the stomach into a special tube while preserving its blood supply and pull it up toward the chest cavity. This newly created gastric tube is connected to the end of the remaining healthy esophagus. In this way, swallowing function continues, and the patient becomes able to eat orally again. This is an ingenious redesign process that ensures continuity of the digestive system. In short, while this surgery aims to eliminate cancer, it also reshapes the body’s anatomy in a way that preserves quality of life.

Who Is Esophageal Cancer Surgery Performed for, and in Which Cases?

The decision for esophageal cancer surgery is made on an individual basis in meetings called a “tumor board,” where specialists from many different disciplines come together. This is not the decision of a single doctor, but a joint decision by a team. The most basic requirement for surgery to be an option is that the cancer has not spread beyond the esophagus and nearby lymph nodes, meaning it has not metastasized to distant organs such as the liver or lungs.

There are some important factors we evaluate when determining suitability for surgery.

The patient’s overall health condition is the most important part of this equation. Esophageal cancer surgery is a major challenge for the body. Therefore, the patient’s heart and lungs must be strong enough to withstand this significant stress. With detailed pre-operative tests, it is carefully evaluated whether the patient is ready for this surgery. Although advanced age alone is not an obstacle, serious accompanying health problems may increase surgical risk.

In today’s modern approach, instead of performing surgery directly in many patients, a pre-treatment preparation called “neoadjuvant treatment” is applied first. This usually consists of chemotherapy and/or radiotherapy. The purpose of this treatment is to shrink the tumor, make the surgery technically easier and safer, eliminate cancer cells that cannot be seen with the naked eye, and ultimately increase the success of the surgery.

The comprehensive evaluation process performed before the decision for surgery includes the following steps:

• Endoscopy and biopsy
• Computed tomography (CT)
• PET-CT scan
• Endoscopic ultrasound (EUS)
• Detailed heart and lung tests

As a result of all these evaluations, if the cancer is in a controllable state and the patient’s overall health permits, esophageal cancer surgery is planned as the most effective treatment option.

What Are the Risks of Esophageal Cancer Surgery?

It is important to know that esophageal cancer surgery is a major and complex operation. Despite all advances in technology and medicine, this surgery, like any major surgical intervention, carries certain risks. Discussing these risks openly and honestly is an important part of the treatment process. The experience of the center where the surgery is performed and the expertise of the surgical team play a vital role in minimizing these risks.

One of the most important problems that can be encountered after surgery is leakage at the new connection point made between the esophagus and the stomach. This condition, medically called an “anastomotic leak,” is the complication we fear most. Because it can lead to serious infections in the chest cavity and often requires another intervention. To reduce this risk, using special technologies during surgery and creating the connection in the safest way possible are our top priorities.

Performing the surgery within the rib cage makes the lungs sensitive. Not being able to breathe deeply enough or cough due to post-operative pain can predispose to the development of lung infection (pneumonia). Therefore, breathing exercises after surgery and getting the patient up and moving as soon as possible are of great importance.

During surgery, especially while removing lymph nodes in the neck region, the nerves leading to the vocal cords are in very close proximity. Injury to these nerves can cause temporary or, rarely, permanent hoarseness and an increased risk of food entering the windpipe during swallowing (aspiration). This also increases the risk of lung infection. Precision technologies such as robotic surgery help protect these nerves better.

Some important risks of esophageal cancer surgery include:

• Leakage at the connection site (anastomotic leak)
• Lung problems (pneumonia)
• Heart rhythm disturbances
• Injury to the vocal cord nerve
• Lymph fluid leak (chylothorax)
• Blood clotting in the veins

Each of these risks can be managed with close follow-up and appropriate interventions after surgery. It should not be forgotten that this surgery is a life-saving procedure, and its potential benefits far outweigh its risks.

How Is Esophageal Cancer Surgery Performed?

Over the years, esophageal cancer surgery has undergone major changes with the help of technology. In the past, these surgeries were performed only with the “open” method, meaning with large incisions made in the abdominal and chest walls. While this method provided the surgeon with a wide field of view, it was an approach that prolonged the patient’s recovery process, caused more pain, and led to more lung-related problems in particular.

Today, the gold standard is “minimally invasive,” meaning closed methods. In these methods, instead of large incisions, a camera and special surgical instruments advanced through a few small openings are used. The most advanced and most precise form of this approach is “robotic surgery.”

In robotic surgery, the surgeon sits at a console and controls the robotic arms inside the patient’s body. This system offers very important advantages compared to traditional closed surgeries. There are some key advantages provided by robotic surgery.

• Three-dimensional, clear visualization
• More precise movements than the human hand
• Tremor-free surgery
• Less blood loss
• Faster recovery
• Less pain
• Lower risk of pulmonary complications

With this technology, the surgeon sees the surgical field magnified 10–15 times and in three dimensions. This allows delicate structures such as vessels and nerves to be distinguished and protected much more clearly. The robot’s arms can make precise movements that can rotate 540 degrees in very small and narrow areas that the human hand cannot reach. This enables much more meticulous removal of lymph nodes, especially deep within the chest cavity.

In addition, in modern surgery we also use a technology called “ICG fluorescence angiography.” Before creating the stomach-esophagus connection, which is the most critical stage of the surgery, a special green dye is given intravenously. With an infrared camera, we observe how this dye highlights blood circulation in the stomach tissue. This method provides us with a roadmap showing which part of the stomach has the best blood supply. In this way, by creating the connection on the healthiest tissue, we significantly reduce the risk of the “anastomotic leak” that we fear most after surgery. Thanks to these technological innovations, esophageal cancer surgery has now become a much safer and far more comfortable process for the patient.

Post-Operative Process After Esophageal Cancer Surgery

The hospital period after surgery is a careful and planned phase during which the foundations of your recovery are laid. This process usually begins in the intensive care unit and continues step by step with the transition to the regular ward. We will be by your side as a team to ensure everything goes smoothly.

As soon as the surgery is finished, you typically spend your first 1–2 days in the intensive care unit, where your vital functions are monitored very closely. Our aim here is to ensure that your body comes through the stress of the operation in the safest way possible. Keeping your pain under control is one of the most important priorities of this process. Your pain is usually kept at a minimum level with a thin catheter placed in your back (epidural catheter) or with painkiller pumps that you control. Having minimal pain is critical so that you can breathe and cough comfortably and start moving as soon as possible.

After being transferred from the intensive care unit to the regular ward, your recovery process accelerates. During this period, physiotherapists help you keep your lungs clear and strong by having you do breathing exercises. From the first day after surgery, we encourage you to get out of bed and take short walks. Early movement regulates blood circulation, reduces the risk of clots, and helps your intestines start working again.

You will not be able to eat by mouth for the first few days after surgery. The nutrients your body needs are usually delivered through a thin tube placed into your small intestine through the abdomen (feeding jejunostomy). About a week later, a contrast study is performed to ensure the new connection has healed. If everything is in order, you first begin drinking water and then gradually move on to liquid and pureed foods.

The main focus points of your recovery process in the hospital are:

• Effective pain control
• Breathing exercises
• Early standing up and walking
• Support through a feeding tube
• A slow and safe transition to oral feeding

Your length of hospital stay is on average 10–14 days, depending on the type of your surgery and your recovery speed. In this period, our goal is to send you home safely and in a condition where you can meet your basic needs on your own.

What Those Who Have Undergone Esophageal Cancer Surgery Should Pay Attention to

When you return home after surgery, a new period begins in your life. Getting used to your body’s new anatomy and making some permanent changes in your lifestyle are a natural part of this process. The most important changes will be in your eating habits. Since your stomach is now smaller, you need to adjust your eating routine to this new situation.

The basic rules of your new nutrition plan are quite simple and will become a habit over time.

• Small and frequent meals
• Eating slowly
• Chewing bites well
• Not consuming liquids with meals
• Sitting upright after meals

Not lying down for at least 1–2 hours after eating is very important to prevent stomach contents from flowing back into the esophagus (reflux). Keeping your head elevated while sleeping at night will also help you.

What you eat is as important as how much you eat. At the beginning, you should prefer soft, pureed, and easily digestible foods. Over time, you can diversify your diet. There are certain food groups that you should prioritize in your diet:

• Soft proteins (chicken, fish, eggs)
• Well-cooked vegetables
• Pureed fruits
• Yogurt, kefir
• Complex carbohydrates (whole wheat bread, bulgur)

Some foods may cause discomfort called “dumping syndrome,” which occurs when food passes too quickly into the intestines. This condition can cause symptoms such as sweating, palpitations, nausea, and diarrhea. Therefore, especially in the first months, it is useful to be cautious with certain foods.

• Sugary drinks and desserts
• Chocolate, pastries
• Very fatty and fried foods
• Very hot or very cold drinks
• Getting support from a dietitian during this process will greatly help you learn proper and balanced nutrition. Remember, this is an adaptation process. Over time, your body will get used to its new order, and you will learn through experience what works for you and what does not. Life after esophageal cancer surgery is a new beginning that requires patience and care. However, with the right approach, many patients can gradually return to an active and high-quality life.