Esophageal cancer is a common malignant tumor in human beings, accounting for 2% of all malignant tumors and more than 90% of esophageal tumors, and ranking 2nd after gastric cancer in all retrospective surveys of malignant tumor deaths. It is estimated that about 200,000 people die from esophageal cancer worldwide every year, and China is a high incidence area of esophageal cancer. Esophageal cancer is one of the most common malignant tumors which is very harmful to people’s life and health. However, in recent years, there is a growing trend for those under 40 years old. The occurrence of esophageal cancer is related to nitrosamines, chronic irritation, inflammation, trauma, genetic factors and the content of trace elements in drinking water, food and vegetables, but the exact causes are not well understood and need to be researched. Most of the treatments for esophageal cancer are mainly surgical treatments. What should be done before surgery to treat esophageal cancer? How should we take care of it after surgery? Pre-operative care 1.Psychological care: Patients with esophageal cancer have progressive swallowing difficulties, are getting thinner and thinner, have poor tolerance to surgery, lack confidence in treatment, and have a certain degree of fear of surgery. Therefore, patients should be explained, consoled and encouraged according to their psychological state, and a fully trusting nurse-patient relationship should be established to make patients realize that surgery is a thorough treatment method and make them happy to accept the surgery. 2.Strengthen nutrition: For those who can still eat, a liquid or semi-liquid diet with high calorie, high protein and high vitamin should be given. For those who cannot eat, water, electrolytes and calories should be supplemented intravenously. For patients with hypoproteinemia, blood or plasma protein should be transfused to correct it. 3. Gastrointestinal preparation: ① Pay attention to oral hygiene; ② Place a gastric tube and duodenal drip tube before surgery; ③ Fasting before surgery, and for those with food retention, rinse the esophagus with isotonic saline the night before surgery, which helps to reduce tissue edema and decrease the incidence of postoperative infection and anastomotic fistula; ④ For those who intend to perform colonic substitution for esophagus, preoperative care must be prepared according to colon surgery, see preoperative preparation for colorectal cancer. 4. Pre-operative exercises: teach patients activities such as deep breathing, effective coughing, sputum evacuation and bed defecation. Postoperative care Building confidence Spiritual factors largely influence the function of immune system, and some scholars believe that the occurrence of disease is the result of imbalance between spirit and organism. People who have confidence in overcoming cancer and living tenaciously will have good “foci of excitement” of hope and expectation in their brains, which will be passed through the limbic system of the brain. This good “focal point of excitement” can enhance the immune activity and inhibit the growth of cancer cells. The reasonable diet of cancer patients consumes a lot after surgery, due to the loss of appetite, the nutritional intake is mostly insufficient. Reasonable dietary principles are: 1. high protein, protein-rich food: such as lean meat, eggs, beans, milk and various essential amino acids to maintain the balance of amino acids in the body can inhibit the development of cancer; 2. high calorie: esophageal cancer patients have poor appetite and difficulty in eating after surgery, so they should eat more lipids and sweets that can be easily digested and absorbed, such as honey, cane sugar, vegetable oil and cream; 3. high vitamin: rich in Vitamin A, C, E, K, folic acid, such as fresh vegetables, fruits, animal liver, etc.; 4, rich in trace elements: such as shiitake mushroom, kelp, nori, egg yolk, pumpkin, cabbage, animal’s liver and kidney, ginseng, wolfberry, yam, lingzhi, etc. The minerals they contain, such as selenium and molybdenum, have anti-cancer effects. After esophageal cancer surgery, there will be various discomforts in chest and stomach, such as panic, chest tightness, etc. Therefore, there should not be too much food each time, and it is appropriate to have small amount and multiple meals. Because of the anastomosis, patients are prone to reflux symptoms after eating, so it is better to move around for a while after eating and rest in bed after 30 minutes, so that the food in the stomach can be partially discharged to reduce reflux. Timely and regular review The first review is usually scheduled about 3 months after surgery, in order to understand the patient’s postoperative recovery and whether there are complications, such as anastomotic stenosis, postoperative gastrointestinal dysfunction, malnutrition and metastasis. Therefore, some necessary examinations such as superficial lymph nodes metastasis, blood count, esophagogram, etc. should be performed to treat the problems in time. The second review is done 1 year after surgery*. Most of the patients in the middle and late stage have metastasis or recurrence 1 year after surgery, which often manifests in metastasis of supraglottic lymph nodes, mediastinal metastasis compressing the trachea and invading the recurrent laryngeal nerve, with respiratory symptoms and hoarseness, and blood in sputum. On review, we should find out whether the anastomosis is recurrently narrowed, whether there are metastases in the lungs, and abdominal ultrasound to exclude liver metastases. and other corresponding parts of the body that may show metastatic symptoms. Postoperative continued treatment for esophageal cancer should be planned and comprehensive treatment should be carried out for those who are found to have cancer cells in the residual of esophageal dissection into known lymph node metastasis in the resected part after postoperative pathological examination. Generally, 20-30 days after surgery, chemotherapy should be given in courses, and 3-5 courses of chemotherapy should be given within 2 years. If the primary foci can be removed by surgery or the cancer tissue has invaded the nearby organs and cannot be completely removed, metal markers should be made at the residual tissues and radiotherapy should be started 3-6 weeks after surgery.