Type of Surgery
Last updated: 02/17/2009
Immediately after surgery the patient will be taken to a recovery area where the pulse, body temperature, and heart, lung, and kidney function will be monitored. Several hours later, the patient will be transferred to a concentrated care area. Surgical...
wound dressings will be kept clean and dry. Pain medication will be given as needed. A chest tube inserted during surgery will be checked for drainage and removed when the drainage stops. A nasogastric (nose to stomach) tube, also placed during surgery, will be used to drain stomach secretions. Nurses will check it regularly and rinse it out. It will eventually be removed by the surgeon. Until the patient is able to swallow soft foods, he or she will be fed intravenously or through a feeding tube that was placed in the small intestine during surgery. Patients will be encouraged to cough and to breathe deeply after surgery to fully expand the lungs and help prevent infection and collapse of the lungs. Walking and movement will also be encouraged to promote a quicker recovery.
About 10â€“14 days after the surgery, the patient will be given another barium swallow so that the doctor can examine the esophagus for any areas of leaking fluid. If none are seen, the nasogastric tube can be removed. The patient can then begin to sip clear liquids, followed gradually by small amounts of soft foods. Patients being treated for esophageal cancer may begin chemotherapy (cytotoxic or cell-killing medications), radiation therapy, or both, before or soon after discharge from the hospital. Patients typically remain in the hospital as long as two weeks after surgery if no complications have occurred.
When the patient goes home, any remaining bandages must be kept clean and dry. Frequent walking and gentle exercise are encouraged. Because laparoscopic and thorascopic surgery is less invasive and uses only small incisions, there is less trauma to the body, and activity can be resumed more quickly than with open procedures that require larger incisions. The patient should report any fever or chills, persistent pain, or incision drainage to the surgeon. The patient's diet will typically be restricted for a while to soft foods and small portions; a normal diet can be resumed in about a month, but with smaller quantities. Patients are advised not to drive if they are still taking prescribed narcotic pain medications. Daily care and assistance at home is recommended during the recuperation period. Regular medical care and periodic diagnostic testing, such as endoscopic ultrasound, is essential to monitor the condition of the esophagus and to detect recurrence of the cancer or the development of new tumors.
An esophageal resection is the surgical removal of the esophagus, nearby lymph nodes, and sometimes a portion of the stomach. The esophagus is a hollow muscular tube that passes through the chest from the mouth to the stomachâ€”a "foodpipe" that carries food and liquids to the stomach for digestion and nutrition. Removal of the esophagus requires reconnecting the remaining part of the esophagus to the stomach to allow swallowing and the continuing passage of food. Part of the stomach or intestine may be used to make this connection. Several surgical techniques and approaches (ways to enter the body) are used, depending on how much or which part of the esophagus needs to be removed; whether or not part of the stomach will be removed; the patient's overall condition; and the surgeon's preference.
In 2000, children's risk of surgery increased from 17.9% in 1981 to 20.2% in 1998/99, while ENT surgery rates increased by 21% over the period.
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