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DO’S and DON’TS after Esophageal Cancer Surgery
In general, the wound needs a change of dressing every 3 to 4 days. Keep the wound dry and try not to sweat. Do not remove the gauze. The stitches from the chest tubes will be removed in about two weeks.
Note: After some patients are discharged from the hospital, the wound where the chest tube was placed will bleed out light yellow or light red fluid, which is often sprayed out when coughing. Please rest assured, if the fluid amount is not too much, treatment is not required. Just disinfect and take care of the wound. However, if fluid or even air come out of the wound every time you cough, consult a doctor immediately. In addition, if the wound is bleeding pus and swelling, please seek medical treatment in a timely manner.
After the patient is discharged, moderate exercise is recommended, such as deep breathing, coughing and expectoration, as well as walking. Strenuous activity is prohibited. If there is no special requirement, it is not recommended to stay in bed constantly.
3、 Dietary taboos：
Esophagogastric anastomosis is still in the healing process shortly after surgery. Excessive mechanical stimulation may aggravate scar hyperplasia and lead to anastomotic stenosis. Therefore, hard food should be avoided for 3 months after surgery. Soft semi-fluid diet will be appropriate, And then gradually transitioning to a normal diet. Patients can eat fish, soy products, and other high protein food. If you have symptoms of dysphagia, you should consult a doctor promptly. If necessary, endoscopic dilatation treatment should be performed.
4、 Diet habits：
After esophagectomy and gastroesophageal replacement, the stomach enters the chest cavity from the abdominal cavity. The original anatomical site was changed; overeating leads to gastric dilation, which can cause compression of the heart and lungs, leading to symptoms such as chest tightness and shortness of breath. Therefore, the amount eaten should be kept track of. Each meal should not be excessive; it should be about half of the original food intake. The frequency of food intake should be increased to 5 to 6 times a day. Patients might need to change their habit of food preparation other than their family.
5、 Post-meal positioning：
The original anti-reflux mechanism after esophagectomy and gastroesophageal replacement is impaired, which may aggravate gastric acid reflux and lead to anastomotic inflammation and even aspiration. Therefore, do not lie down immediately after eating, maintain regular activity for 1 hour before lying down to rest. In addition, when sleeping at night, try to keep a sloped position (using multiple pillows); If you often feel acid reflux or heartburn, go to the hospital to seek reflux symptoms treatment.
Incision pain and paresthesia are normal phenomena after surgery. Tissue healing and nerve regeneration are long processes, please do not worry too much. The pain after surgery may last for 3 to 6 months. Consult a physician or visit a hospital if there is a persistent pain.
7、 Other symptoms
After esophagectomy and gastroesophageal replacement, due to the interference to the abdominal organs, abnormal digestive function may occur, such as diarrhea, constipation and other symptoms. If the symptoms are mild, they can be adjusted by diet; it is recommended to eat more vegetables and fruits, and less spicy and greasy food.
Some patients need to have postoperative 4 ~ 6 cycles of chemotherapy as part of comprehensive treatment. Generally speaking, patients need to consult their physician 1 month postoperatively about chemotherapy. Please drink water as much as possible, and consume more fruits and vegetables during chemotherapy. It is best to intake selenium tablets that contain malt selenium and vitamin E to effectively alleviate the side effects of chemotherapy drugs. It is also recommended that patients have a blood routine examination every 2-3 days until two weeks after chemotherapy