Esophageal reconstruction surgery is suitable for esophageal cancer lesions in the middle or lower 1/3 of the esophagus without distant metastasis. The surgery usually involves cervical, thoracic and abdominal incisions and reconstruction of the esophagus with the stomach or large intestine.

The purpose of esophageal reconstruction surgery is to maintain the normal function of the digestive tract. After resection of the tumors, patients can eat normally by mouth to maintain proper nutrition.

Precautions before Operation

• Quit smoking.
• Breathing training: The use of ventral deep breathing spirometer will be taught by respiratory therapists.

Abdominal breathing: Take a semi-sitting position, put your hand over your navel, pucker your lips as if going to whistle, inhale through your nose, and then close your breath for 3 seconds after the abdomen is fully raised, then exhale slowly through your mouth. Repeat the above exercise about 8 to 10 times an hour.

• Intestinal preparation: 3 days before surgery, take low-residue diet (e.g. sponge gourd, wax gourd and other non-root vegetables, meat, fish, and fruit juice without granules). Two days before the operation, switch to liquid diet (e.g. rice soup and sports drinks), together with laxatives.
• No food or water midnight (12 a.m.) before surgery.
• Skin preparation: shave chest, abdomen and underarm hair.

Precautions after Operation

• Nutrition supplement: Patients with esophageal cancer may have poor swallowing ability or post-operative limitations, so they cannot get all the nutrition they need by mouth. They can increase their calorie intake by the following ways.
  1. Intravenous therapy: fluids and electrolytes may be replenished, but calories are limited.
  2. Gastrostomy: Make a permanent or temporary passage on the abdominal wall directly into the stomach for the purpose of feeding and providing adequate nutrition.
  3. Jejunostomy: same as above, the proximal jejunum is made into a channel.
  4. Prepare 2000ml a day and infuse it every 3-4 hours, each time no more than 350 ml.
• Defecation pattern: Attention should be paid to constipation, diarrhea or black stool. If it occurs, please inform the medical staff to help deal with it.
• Eating situation: if you often choke on or cough up food while eating, you should immediately tell the medical staff to deal with it.
• Wound care: Observe whether the skin around the wound and the stoma is red, damaged, and whether there are signs of infection such as redness, swelling, hotness, pain and abnormal secretion.

Postoperative Tubes

• Nasogastric tube: it is well fixed and cannot slide out. If it slides out, please inform the medical staff. Do not push it back to the external decompressor or let the liquid drain naturally.
• Chest tube
  • Change position in bed every 2 hours to promote comfort and drainage.
  • Squeeze the tube with both hands to prevent clots from blocking. Do not twist the tube.
  • The drainage bottle should be fixed, not overturned, and should not be placed higher than the wound to avoid countercurrent.
  • The wall-mounted evacuator continues to bubble to maintain good suction function.