The incidence of esophageal cancer and cardia cancer is high in China, and surgery is the main means to treat early and middle stage esophageal cancer and cardia cancer. Surgery is performed to remove the diseased esophagus and cardia, and at the same time, the vagus nerve running down the esophagus is severed, and the stomach is lifted into the chest cavity or the neck is anastomosed with the upper end of esophagus. The surgery is very traumatic, and the physiological anatomy of the gastrointestinal tract is obviously changed.
So, what issues should patients pay attention to after surgery for esophageal cancer and cardia cancer?
First of all, due to the loss of normal cardia anti-reflux function after surgery and the absence of vagus nerve function, the food in the stomach will easily reflux into the esophagus. Therefore, the patient should have a small number of meals after surgery, each meal should not be too full, do not lie down immediately after the meal, let alone lying down to eat, should sit still or take a proper walk for about 30 minutes after the meal and then go to bed, when sleeping, the head of the bed should be raised or the upper body should be padded at a certain angle to prevent food reflux in the stomach.
Secondly, because the stomach is lifted into the chest cavity, directly adjacent to the heart and lungs, so too much food can easily lead to the expansion of the stomach volume, affecting the heart and lung function, especially the original heart and lung function is poor, the patient may have chest tightness, shortness of breath, panic and other symptoms after a full meal, so the patient should not eat too much at each meal, but a small amount, more meals. Do not be overly alarmed by these symptoms, rest for a period of time and wait for the emptying of food in the stomach into the intestinal tract, the symptoms can be gradually relieved. If the symptoms are not relieved for a longer period of time, you should go to the hospital and take the necessary measures. Several months or years after the operation, the patient’s own regulation ability will gradually increase, the patient can gradually adapt, and the occurrence of such symptoms can be gradually reduced.
Third, the esophageal and gastric anastomosis is “hard” and lacks the elasticity of normal esophageal and gastric tissues. “Otherwise, it is easy to get stuck or hang at the anastomosis, which may cause nausea, vomiting and other discomforts in addition to obvious choking, and affect normal eating.
Fourthly, due to the change of the position of the stomach, it is in the negative pressure environment in the thoracic cavity, and at the same time, due to the lack of vagus nerve function, the gastric emptying is slowed down for a period of time after the operation, and gastrointestinal tract dysfunction easily occurs. In addition to acid reflux and heartburn, patients will also experience fullness and poor appetite, which can be relieved by taking oral gastrodynamic drugs and acid suppressants such as morpholine and omeprazole. Some patients may also have diarrhea due to gastrointestinal tract dysfunction. At this time, patients should avoid eating greasy food to avoid aggravating diarrhea, and if diarrhea still does not stop after dietary adjustment, antidiarrheal drugs may be added appropriately.
Fifthly, due to the damage of intercostal nerve in esophageal cancer and pancreatic cancer surgery, the incision may feel pain like pins and needles or numbness for a long time after surgery, and the pain may be more obvious when the weather changes.
Sixth. The surgery consumes a lot of patients, and some of them may need to cooperate with radiotherapy or chemotherapy after surgery, so they should strengthen nutrition properly after surgery, and all kinds of food can be eaten as long as they are light, fresh, nutritious and easy to digest, avoiding spicy and stimulating food, and prohibiting smoking and alcohol. If possible, biological agents such as interferon or thymidine can be applied to improve the immunity of the body, or traditional Chinese medicine and tonic products can be applied to speed up the recovery of the body.
In addition, patients should insist on regular review and follow-up after surgery, once every three months for two years after surgery, then once every six months, and can be extended to once a year after the fifth year, so that various problems can be found at any time and dealt with in time.