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Procedural / Technique
thoracic
High-impact pattern

Esophagectomy: aspiration protection, invasive monitoring, and OLV

Anesthetic priorities for transthoracic esophagectomy

Esophagectomy is major surgery for esophageal cancer or selected benign obstruction; anesthesia centers on aspiration protection, invasive monitoring for large fluid shifts, and management of prolonged one-lung ventilation.

If you forget

Treat esophageal dysfunction as an aspiration-risk problem: use rapid-sequence induction with cricoid pressure for carcinoma-associated reflux.

Board trap
The examiner may ask why left internal jugular access is avoided: a cervical esophageal anastomosis may be created in the left neck, so right internal jugular access is preferred when feasible.

Key numbers

  • 10%–15%: reported morbidity and mortality rate for this major procedure.
  • T6–L1: neuraxial blockade range that disrupts splanchnic sympathetic innervation.
  • 20%: nausea and vomiting may occur with neuraxial block.
Reviewed Oct 8, 2026 for clinical accuracy by BoardsBridge Editorial Process

Uri Rozen, MD — Licensed Physician, Israel

Source guidelines: Millers Anesthesia 10 Ch49 Anesthesia FOR Thoracic Surgery · Millers Anesthesia 10 Ch41 Spinal Epidural AND Caudal Anesthesia

Re-review cadence: 12 months from reviewed date.

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Related on BoardsBridge

Card ID: esophagectomy · Path: aba.thoracic.esophageal.esophagectomy

Educational reference only. Reviewed for clinical accuracy against current authoritative guidelines. Not a substitute for clinical judgment. See editorial process and the sitemap entry for this card.