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Life after an oesophagectomy or gastrectomy

Life after an oesophagectomy or gastrectomy

After your operation
If you have an oesophagectomy performed, you will be looked after on an
intensive care unit (ICU) usually for a day or two. This does not mean you have
complications; it is standard procedure. A ventilator may be used to help you to
breathe. Patients who have a gastrectomy do not routinely go to ICU but will go to
the overnight recovery unit.

Pain
It is very important that pain is controlled adequately: –

• for comfort;
• to enable effective breathing and to minimise the risk of chest problems;
• to enable better mobility – vital for breathing, increasing muscle strength
and stamina and to avoid deep vein thrombosis.

You may experience some pain and/or discomfort after the operation. Most
patients will have pain controlled using an epidural. This is a fine plastic tube that
is inserted into the space around your spinal cord so that a drug can be given to
numb the nerves. Your doctor or nurse will explain this procedure to you. Pain
killing drugs can also be given through the feeding tube, mouth or intravenously
(through a vein). The Acute Pain Team monitors pain control after surgery. It is
vital to let your nurse or doctor know if your pain is not under control.

Drips, drains and tubes
A drip will be used to give you fluids until you are able to eat and drink again. You
may also have a naso-gastric (NG) tube. This is a fine tube that passes down your
nose into your stomach and allows any fluids to be removed so that you don’t feel
sick. This helps the area of the operation to recover. You will have chest drains in
place for a few days – this always applies to an oesophagectomy, not always for a
gastrectomy. These tubes are inserted into your chest during the operation to
drain away any fluid that may have collected around the lungs. The fluid drains
into a bottle beside your bed.

A Jejunostomy tube (Jej tube) is normally inserted into the abdomen during an
oesophagectomy. This is the tube through which you will be fed while you cannot
eat and drink or as a top-up to your nutrition in the early weeks following surgery.
Patients who undergo a gastrectomy will not have a Jej tube inserted as they are
likely to get back to eating and drinking more quickly.

Breathing after your operation
During your post-operative recovery period, a Physiotherapist will teach you
exercises to re-expand your lungs to enable you to clear any mucus that has built
up in your lungs during the operation. They will also show you how to cough
effectively with your wound supported. They will also assist you to walk from the
first day after your operation as this promotes lung re-expansion.

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