Anesthesiology pp 119-130 | Cite as

Anesthesia for Esophageal Surgery

  • Christopher Ma
  • J. Kirk EdwardsEmail author


This chapter covers the three major esophageal surgical categories: esophagogastroduodenoscopy (EGD) with stenting, fundoplication/hiatal hernia repair, and esophagectomy. For each surgery, a brief review of the inciting pathology and procedure technique is followed by preoperative and intraoperative anesthetic considerations. At the end of this chapter, postoperative anesthetic considerations relevant to all surgical types are discussed.


Esophageal surgery Esophagogastroduodenoscopy EGD Esophageal stenting Fundoplication Laparoscopic Nissen Hiatal hernia Esophagectomy Transhiatal McKeown Ivor Lewis Esophagus Belsey Trupet Collis-Belsey 


  1. 1.
    Kuo B, Urma D. Esophagus—anatomy and development. Part 1 Oral Cavity, pharynx and esophagus. GI Motility online. 2006. doi:
  2. 2.
    Linden PA. Chapter 29. Overview. In: Sugarbaker DJ, Bueno R, Krasna MJ, Mentzer SJ, Zellos L, editors. Adult chest surgery. New York, NY: McGraw-Hill; 2009. Accessed 30 Mar 2017.Google Scholar
  3. 3.
    Krasna M, Ebright M. Chapter 10. Overview. In: Sugarbaker DJ, Bueno R, Krasna MJ, Mentzer SJ, Zellos L, editors. Adult chest surgery. New York, NY: McGraw-Hill; 2009. Accessed 30 Mar 2017.Google Scholar
  4. 4.
    American Society of Anesthesiologists Committee. Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures: an updated report by the American Society of Anesthesiologists Committee on Standards and Practice Parameters. Anes. 2011;114(3):495–511. Scholar
  5. 5.
    El-Serag HB, Sweet S, Winchester CC, Dent J. Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut. 2014 Jun;63(6):871–80. Scholar
  6. 6.
    Broeders JA, Rijnhart-de Jong HG, Draaisma WA, Bredenoord AJ, Smout AJ, Gooszen HG. Ten-year outcome of laparoscopic and conventional nissen fundoplication: randomized clinical trial. Ann Surg. 2009 Nov;250(5):698–706. Scholar
  7. 7.
    Du X, Hu Z, Yan C, Zhang C, Wang Z, Wu J. A meta-analysis of long follow-up outcomes of laparoscopic Nissen (total) versus Toupet (270°) fundoplication for gastro-esophageal reflux disease based on randomized controlled trials in adults. BMC Gastroenterol. 2016;16(1):88. Scholar
  8. 8.
    Spanjersberg WR, Reurings J, Keus F, van Laarhoven CJ. Fast track surgery versus conventional recovery strategies for colorectal surgery. Cochrane Database Syst Rev. 2011;2:CD007635. Scholar
  9. 9.
    Azhar RA, Bochner B, Catto J, Goh AC, Kelly J, Patel HD, Pruthi RS, Thalmann GN, Desai M. Enhanced recovery after urological surgery: a contemporary systematic review of outcomes, key elements, and research needs. Eur Urol. 2016;70(1):176–87. Scholar
  10. 10.
    Melloul E, Hübner M, Scott M, Snowden C, Prentis J, Dejong CH, Garden OJ, Farges O, Kokudo N, Vauthey JN, Clavien PA, Demartines N. Guidelines for perioperative care for liver surgery: enhanced recovery after surgery (ERAS) society recommendations. World J Surg. 2016;40(10):2425–40. Scholar
  11. 11.
    Giménez-Milà M, Klein AA, Martinez G. Design and implementation of an enhanced recovery program in thoracic surgery. J Thorac Dis. 2016;8(Suppl 1):S37–45. Scholar
  12. 12.
    Li W, Li Y, Huang Q, Ye S, Rong T. Short and long-term outcomes of epidural or intravenous analgesia after esophagectomy: a propensity-matched cohort study. PLoS One. 2016;11(4):e0154380. Scholar
  13. 13.
    Madenci AL, Reames BN, Chang AC, Lin J, Orringer MB, Reddy RM. Factors associated with rapid progression to esophagectomy for benign disease. J Am Coll Surg. 2013;217(5):889–95. Scholar
  14. 14.
    Peyre CG, Sugarbaker DJ. Three-hole esophagectomy: the brigham and Women’s hospital approach. In: Sugarbaker DJ, Bueno R, Colson YL, Jaklitsch MT, Krasna MJ, Mentzer SJ, Williams M, Adams A, editors. Adult chest surgery. 2nd ed. New York, NY: McGraw-Hill; 2014.Google Scholar
  15. 15.
    Zeng J, Liu JS. Quality of life after three kinds of esophagectomy for cancer. World J Gastroenterol. 2012;18(36):5106–13. Scholar
  16. 16.
    Committee on Standards and Practice Parameters, Apfelbaum JL, et al. Practice advisory for preanesthesia evaluation: an updated report by the American Society of Anesthesiologists Task Force on preanesthesia evaluation. Anes. 2012;116(3):533–8. Scholar
  17. 17.
    Fleisher LA, Fleischmann KE, Auerbach AD, Barnason SA, Beckman JA, Bozkurt B, Davila-Roman VG, Gerhard-Herman MD, Holly TA, Kane GC, Marine JE, Nelson MT, Spencer CC, Thompson A, Ting HH, Uretsky BF, Wijeysundera DN. 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2012;130(24):2215–45. Scholar
  18. 18.
    Iseli TA, Iseli CE, Golden JB, Jones VL, Boudreaux AM, Boyce JR, Weeks DM, Carroll WR. Outcomes of intubation in difficult airways due to head and neck pathology. Ear Nose Throat J. 2012;91(3):E1–5.PubMedGoogle Scholar
  19. 19.
    Ng JM. Update on anesthetic management for esophagectomy. Curr Opin Anaesthesiol. 2011;24(1):37–43. Scholar
  20. 20.
    Al-Rawi OY, Pennefather SH, Page RD, Dave I, Russell GN. The effect of thoracic epidural bupivacaine and an intravenous adrenaline infusion on gastric tube blood flow during esophagectomy. Anesth Analg. 2008;106(3):884–7. Scholar
  21. 21.
    Klijn E, Niehof S, de Jonge J, Gommers D, Ince C, van Bommel J. The effect of perfusion pressure on gastric tissue blood flow in an experimental gastric tube model. Anesth Analg. 2010;110(2):541–6. Scholar
  22. 22.
    Theodorou D, Drimousis PG, Larentzakis A, Papalois A, Toutouzas KG, Katsaragakis S. The effects of vasopressors on perfusion of gastric graft after esophagectomy. An experimental study. J Gastrointest Surg. 2008;12(9):1497–501. Scholar
  23. 23.
    Wei S, Tian J, Song X, Chen Y. Association of perioperative fluid balance and adverse surgical outcomes in esophageal cancer and esophagogastric junction cancer. Ann Thorac Surg. 2008;86(1):266–72. Scholar
  24. 24.
    Hand WR, Stoll WD, McEvoy MD, McSwain JR, Sealy CD, Skoner JM, Hornig JD, Tennant PA, Wolf B, Day TA. Intraoperative goal-directed hemodynamic management in free tissue transfer for head and neck cancer. Head Neck. 2016;38(Suppl 1):E1974–80. Scholar
  25. 25.
    Gan TJ, Diemunsch P, Habib AS, Kovac A, Kranke P, Meyer TA, Watcha M, Chung F, Angus S, Apfel CC, Bergese SD, Candiotti KA, Chan MT, Davis PJ, Hooper VD, Lagoo-Deenadayalan S, Myles P, Nezat G, Philip BK, Tramèr MR, Society for Ambulatory Anesthesia. Consensus guidelines for the management of postoperative nausea and vomiting. Anesth Analg. 2014;118(1):85–113. Scholar
  26. 26.
    Apfelbaum JL, Silverstein JH, Chung FF, Connis RT, Fillmore RB, Hunt SE, Nickinovich DG, Schreiner MS, Silverstein JH, Apfelbaum JL, Barlow JC, Chung FF, Connis RT, Fillmore RB, Hunt SE, Joas TA, Nickinovich DG, Schreiner MS, American Society of Anesthesiologists Task Force on Postanesthetic Care. Practice guidelines for postanesthetic care: an updated report by the American Society of Anesthesiologists Task Force on Postanesthetic Care. Anes. 2013;118(2):291–307. Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Emory University School of MedicineAtlantaUSA

Personalised recommendations