Before the procedure, the surgeon will have a surgical conversation with you. This includes a summary of what the doctor has said and what previous patients need to know or want to know. You will also have many questions before your surgery, and I’m sure the pre-op talk will give you the answers you want.
What are the possible risks of my surgery?
Usually, the risk of esophageal surgery is influenced by the following factors: advanced age, obesity, malnutrition, smoking, alcohol abuse, comorbid coronary artery disease, congestive heart failure, arrhythmias, chronic obstructive pulmonary disease, diabetes, old cerebral infarction, chronic renal insufficiency, liver cirrhosis, and other chronic diseases.
Short-term surgical risks due to the above factors include: anesthesia accidents, intraoperative hemorrhage, postoperative lower extremity deep vein formation, pulmonary embolism, postoperative pulmonary infection, vocal cord paralysis resulting in hoarseness, anastomotic fistula and stenosis, and postoperative gastric emptying disorder; long-term surgical risks include: postoperative dysphagia, malnutrition, local recurrence of tumor, distant metastasis, and even death.
The more cases of esophageal cancer you see in your thoracic surgery department per year, the more experience you will have in preventing and managing the risk of postoperative complications, and the more detailed the preoperative conversation with your primary surgeon will be. If you have any questions during the conversation, you will need to communicate further, and the physician in charge will be able to answer your questions.
Will I recover well after surgery?
A smooth postoperative recovery is not only related to the surgical procedure, but also to postoperative nutritional support and rehabilitation exercises.
Postoperative nutritional support therapy relies on a nutritional line, so an enteral nutrition tube (usually via the nasal or transjejunal route) will be left in place during esophageal resection and reconstruction. In addition, for postoperative recovery, the surgeon may also place a chest/abdominal/neck drain, as well as a urinary catheter, intravenous line, etc. You will want to avoid touching these tubes during your recovery. The medical staff will also do a good job of managing the various lines for you.
If you need to get out of bed after surgery, it is best not to do it alone, but with the assistance of a family member or caregiver. Modern surgery promotes the concept of enhanced recovery after surgery (ERAS), and after minimally invasive esophageal surgery, your surgeon will encourage you to get out of bed early and remove your catheter as soon as possible.
You should also actively exercise your cough daily to maximize the efficiency of spontaneous expulsion and increase your time out of bed to facilitate recovery from postoperative gastrointestinal evacuation, as directed by your surgeon.
When will the pathology results be available? What follow-up treatment is needed?
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After surgery, the surgeon will usually remove some of the diseased tissue and send it to the pathology department for biopsy to further determine your condition. The time to return post-operative pathology results varies by hospital pathology department and will usually be available in 1 to 2 weeks after surgery.
Based on the postoperative pathology staging results, the physician will develop the next step in treatment, which is postoperative adjuvant therapy, usually starting 4 to 6 weeks after surgery. You only need to follow the postoperative rehabilitation program and resume oral feeding as soon as possible, or continue tube feeding into adjuvant therapy.
The postoperative recovery process requires perseverance and patience, and any successful postoperative recovery requires the combined efforts of the patient, family, and provider, as well as the mental preparation for the risk of postoperative complications.