What Is a Transhiatal Esophagectomy?

Esophageal cancer resection is a surgical method used to treat esophageal cancer, and there are strict choices according to the trial situation.

Esophageal cancer resection

Esophageal cancer resection is a surgical method used to treat esophageal cancer, and there are strict choices according to the trial situation.

Preparations before surgery

In principle, it is the same as the preoperative preparation for other chest surgery, but the following issues should be emphasized:

1. For early esophageal cancer, such as

1. The success of esophageal cancer resection is directly related to the judgment of whether the tumor can be removed during the operation. Mistaking a resectable tumor as an unresectable tumor and giving up surgery, or treating an unresectable tumor as resectable and reluctantly performing surgery will not save the patient's life, but will increase the burden on the patient.

2. The free segment of the esophagus above the anastomosis should not be too long, generally within 5cm, and the muscular layer should be intact without tearing. Do not damage the bowels of the large and small vessels of the stomach, so as to prevent insufficient blood flow and affect the anastomotic healing. The anastomosis of the esophagus and the stomach is best to use the method of nesting or embedding. When stitching the inner layer, the two mucous membranes on both sides must be sewn together, and intermittent sutures can be used to avoid anastomotic narrowing. The sutures in each layer must not be too dense or too tight. Be careful not to tear the esophagus. These are important measures to prevent anastomotic fistulas.

3. When separating the posterior wall of the esophagus, the cut mediastinal tissues should be ligated; be careful not to damage the thoracic duct. If the contralateral mediastinal pleura is ruptured, it should be repaired in time; when it cannot be repaired, the closed thoracic drainage tube should be placed before closing the chest.

4. Use sharp operation to isolate the esophagus as much as possible, and perform necessary ligation and hemostasis, and remove the surrounding lymph nodes along with the tumor. Blunt finger separation is not only difficult to completely remove tumor tissue, but also easy to tear the tumor and its surrounding organs.

5. After the esophagogastric anastomosis under the aortic arch is completed, care should be taken not to narrow the gastric body mentioned in the thoracic cavity when suture the diaphragm; the stitches between the diaphragm and the stomach wall should not be too sparse, and it should also be sewn tightly at the costal corner. So as to avoid diaphragmatic hernia.

6. After the tumor is removed, it can be used when the stomach and colon cannot be used and the esophagus is stumped.

1.Same as others

Measure one

Observe the symptoms of anastomotic fistula

After the operation, esophageal anastomotic fistula is easy to occur. Patients usually show high fever, dyspnea, severe pain in the chest, and intolerable. The affected side has low respiratory sounds, dull dullness, increased white blood cells, and even shock. In view of the above adverse conditions, pleural drainage can be used to promote lung swelling; or effective antibiotics can be selected to fight infection.

Measure two

Strict diet

Fasting is likely after surgery and patients should be rehydrated daily by intravenous fluids. If a duodenal drip tube is placed, after the recovery of peristalsis on the second day after surgery, the nutrient solution will be dripped through the catheter to reduce the amount of infusion. On the fifth day after surgery, if there is no special change in the condition, you can eat by mouth Liquid foods such as milk; On the tenth day after surgery, patients can change to a slag-free semi-liquid diet, but care should be taken to prevent overeating and excessive eating.

Measure three

Close observation of thoracic drainage

After the operation, if abnormal drainage, turbid fluid, food residue, or chyle is found in the pleural drainage fluid, it is indicated that there is active bleeding in the thoracic cavity, esophageal anastomotic fistula, or chylothorax, and appropriate measures should be taken to confirm the diagnosis Be handled.

Esophageal cancer is one of the common malignant tumors in clinical practice. Compared with western medicine, traditional Chinese medicine has unique advantages in treating esophageal cancer. The overall concept of TCM and the advantages of dialectical treatment are improving the survival rate and quality of life of patients. Min has achieved encouraging results in such areas as attenuation. The clinical application of Liying Xiaocan Decoction has been unanimously approved by patients and their families. It is your first choice medicine to get rid of esophageal cancer and regain your health. I hope that all patients with esophageal cancer can recover their health as soon as possible. ^[1]

Early treatment of esophageal cancer is mainly based on surgical resection, so how long can esophageal cancer survive after surgery is a concern for most patients. The key to how long esophageal cancer can survive after surgery lies in the adjuvant treatment received after surgery to consolidate the results of surgery and prevent recurrence. Biological therapy can quickly restore the immune damage caused by surgery, remove residual tumor tissue cells, and prolong patient life.

In the early stage of esophageal cancer, the patient only had a tingling sensation when eating dry food. As the disease gradually worsened, he developed difficulty in eating and swallowing. It can be seen that difficulty in feeding is a very serious problem for patients with esophageal cancer. Early esophageal cancer can be cured very well, but the prognosis is relatively poor, but after effective treatment may also achieve long-term tumor survival.

Patients are usually given esophageal and gastric bypass surgery, gastrostomy, and esophageal endotubation after surgical resection, in order to solve the problem of eating difficulties for patients. However, clinical experience has shown that patients with esophageal cancer have a high possibility of recurrence after six months, so adjuvant treatment to prevent recurrence of esophageal cancer is essential.