Surgery for esophageal cancer removes a portion of the diseased esophagus and makes a tube of the stomach that connects to the remaining esophagus. Because the digestive tract is reconstructed through surgery, your swallowing and digestive function will be altered.
Esophageal cancer surgery is a major surgical procedure, and intraoperative anesthesia, bleeding, surgical strikes, and stress reactions in the body can lead to elevated nutritional risk.
Based on these two points, postoperative nutritional support becomes a key component to reduce postoperative complications and promote recovery.
Esophageal cancer should be treated with enteral nutrition support early (within 24 hours) after surgery. The effectiveness of enteral nutrition needs to consider whether the intestinal motility is restored and whether the anus is exhausted.
Studies have shown that gastric function returns to normal 12 to 24 hours after surgery, colorectal function returns to normal 48 to 72 hours after surgery, and peristaltic, digestive, and absorptive functions of the small intestine return 6 to 12 hours after abdominal surgery. Although esophageal cancer surgery is performed to reconstruct the digestive tract, the replacement organ is most commonly the stomach, and the surgery does not interfere much with the small intestine and colorectum. Therefore, early postoperative enteral nutrition can not only meet the body’s need for nutrients when stress occurs; it also will not aggravate malnutrition due to absorption dysfunction.
Considering the healing of the anastomosis, you will be fasted and dehydrated for about 1 to 2 weeks during your postoperative hospitalization while you are given parenteral or enteral nutritional support. Several studies have shown that enteral nutrition is better tolerated and safer for patients after esophageal cancer surgery, and that enteral nutrition is superior to parenteral nutrition in reducing postoperative complications and shortening the length of stay.
The main routes of enteral nutrition input are, nasal enteral nutrition tube and jejunostomy. The caloric requirement for postoperative esophageal cancer is 25-30 kcal/kg, and the caloric requirement for enteral nutrition is 1-1.5 kcal/ml. Therefore, enteral nutrition should be infused at a gradual incremental rate, initially at 20 ml/h. Depending on your condition, your doctor will increase 20 ml/h daily, gradually increasing to 80-100 ml/h, which will achieve your daily requirement.
To learn more about enteral and parenteral nutrition, please read:
To ensure the amount of nutrient fluid input, nutrition tube-related complications need to be prevented.
1. Abdominal distension: This is a common manifestation after abdominal surgery, and it is possible to move to the floor appropriately to promote gastrointestinal motility, and also to give auxiliary laxative drugs to reduce the symptoms of abdominal distension;
2. Diarrhea: The cause of diarrhea needs to be identified, and if it is related to the nutrient solution, the infusion rate, variety and temperature of the nutrient solution can be adjusted;
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3. Blockage of nutrition tube: The nutrition tube needs to be flushed with water repeatedly to prevent blockage. If obstruction occurs, use soda to pass the tube.
Because the scope of this article is during hospitalization, your healthcare provider will help you deal with these problems in a timely manner. All you need to do is watch for changes in yourself and your nutrition line and talk to your doctor.