There are two major steps in radical esophageal cancer surgery: removal of the tumor and reconstruction of the digestive tract. The main feelings you have after surgery, and the changes in your body, come from these two areas.
After surgery, a portion of your esophagus was removed. To ensure normal function, a portion of the stomach is made into a “tubular stomach” to replace the function of the esophagus, which allows the stomach to enter the chest cavity.
In addition, because of the trauma of esophageal surgery, the whole body is in a state of stress after surgery, with high compensatory heart rate and blood pressure, and the body’s metabolic rate is at a high level, leading to insulin resistance and elevated blood glucose levels.
In order of onset, postoperative body sensations can be categorized into short-term postoperative discomfort (approximately 1 month postoperatively) and long-term discomfort (approximately 1 month postoperatively).
Short-term postoperative discomfort, mainly related to surgery
Short-term discomfort is most commonly associated with postoperative pain, which is what you will feel most viscerally and what your family will be most worried and anxious about.
Doctors and nurses have corresponding judgments about the different sources, types, and levels of pain. There are different medications for different modes of pain.
Traditional methods of postoperative analgesia include oral medications, intramuscular, subcutaneous, intravenous medications, and rectal administration. There are now also epidural analgesia and patient-controlled analgesia (analgesic pumps) to assist.
You may also have other discomforts after surgery, such as coughing after general anesthesia (mainly due to tracheal tube irritation during general anesthesia surgery), coughing up sputum (which predisposes to lung infection after thoracic surgery), impaired gastrointestinal emptying, dizziness and nausea, elevated body temperature (usually no more than 38 °C), and sometimes postoperative complications.
Long-term discomfort after surgery, mainly focused on diet
Post-operatively, you have been feeding primarily through nasal nutrition, gradually transitioning to transoral feeding. The timing of feeding varies, as does the duration of nutrition and tube feeding, depending on your surgeon’s personal habits and the differences in your physical condition.
Usually 1 to 2 months after discharge, your swallowing and chewing functions begin to gradually return; your ability to eat is gradually restored as your digestive tract is reconstructed. You will need to adapt to your new eating habits and follow the principle of “eat small meals and chew slowly.
After esophageal cancer surgery, you may experience slow weight loss, often lasting more than 1 year.
The loss is usually fastest in the first month, due to the inability to meet your body’s needs with the calories you eat by mouth, including sugar, fat, protein, and vitamins. The continued decrease in weight can lead to a decrease in the body’s immunity, which can have a negative impact on the prognosis of the tumor.
Multi-center studies have confirmed that postoperative patients with esophageal cancer require a dedicated nutrition clinic or nutrition team to assist with nutritional guidance. To avoid rapid weight loss in postoperative patients, it is also important to assess you for malnutrition before surgery and to provide nutritional interventions in advance.