The oesophagus is located at the back of the chest making it a difficult place to access. Three different surgical approaches may be used depending on the size and location of the cancer. The approach will be discussed on an individual basis to establish the most suitable for each patient. Where appropriate, laparoscopic (keyhole) techniques are used to keep the incisions to a minimum.
To replace the removed oesophagus, a tube is made from the stomach, which is pulled up into the chest and joined to the remaining oesophagus.
The surrounding tissues including lymph nodes are also removed at the time of surgery as these may also contain cancer cells. The analysis of this tissue gives information on the extent or “stage” of the cancer.
Frequently Asked Questions
Most patients are in hospital approximately 10 days. The majority of the recovery time is getting used to an oral diet after the surgery. Most patients are ambulatory at 4-5 days after surgery.
The main concern after surgery is to ensure there is no failure of the join made between the bowel. For this reason, it is common practice to perform a contrast test a few days after the procedure to check the join before an oral diet is started. This involves drinking fluid whilst an x-ray is taken.
If a failure or leak is detected then further surgery maybe required. However, these situations are not common and can often be managed expectantly.
It is very important after surgery to ensure that breathing exercises are performed regularly. Physiotherapists are a crucial part of post-operative recovery as they prevent post-operative chest infections by encouraging deep breathing and early mobilisation.
You will not be allowed to leave hospital until you can walk up a flight of stairs unaided and can perform all the tasks, which will be required when you get home.
It usually takes 4-6 weeks before patients feel they can go back to work after the more major procedures. It is not uncommon to feel tired for the first few months after surgery. If further chemotherapy is required this will extend the period of recovery. For some patients it will take between 6 to 12 months to regain normal quality of life after their treatment.
Driving should be avoided for the first few weeks after surgery. Once you can perform an emergency stop in a stationary vehicle and turn to view your blind spot then driving should be safe. It is preferable to contact your insurance company to check for any specific instructions they may have.
You will be seen regularly after the surgery as part of a formal follow up plan. Any difficulties with eating will be discussed and your weight will be monitored. You will also be checked for any vitamin or iron deficiencies after the surgery.
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