An introduction to the common complications of esophageal cancer in clinical practice

Patients with esophageal cancer must receive early treatment, otherwise there will be many complications of esophageal cancer. So what are the complications of esophageal cancer? Esophageal cancer is already affecting the normal lives of patients. Now, let the experts introduce to you the complications of esophageal cancer .

1. Chylothorax: Normal people have a thoracic duct that drains lymph fluid near the middle and lower parts of the esophagus. It is possible to damage it when separating the esophagus during surgery. If esophageal cancer invades the surrounding tissues seriously, the possibility of thoracic duct damage during surgery is greater. Thoracic duct damage can often be manifested 24 hours after surgery, and the drainage volume of the chest drainage tube is usually more than 500 ml per day. If the patient starts to eat, the drainage volume will be greater. The patient may have symptoms such as chest tightness, shortness of breath, and palpitations. Chest radiographs can reveal a large amount of fluid in the chest cavity. Once chylothorax is confirmed, closed chest drainage should be performed in time to remove the effusion and re-expand the lungs to facilitate the healing of the thoracic duct injury. If the chylous fluid flow does not decrease after the above treatment and close observation for 2 to 3 days, the chest should be opened again to suture and ligate the ruptured thoracic duct. The delay should not be too long, so as to avoid excessive nutritional consumption of the patient and increase the risk of surgery. This is a complication of esophageal cancer.

2. Anastomotic fistula: This is a serious complication of esophageal cancer after esophageal cancer surgery, with a general incidence of about 5%. The incidence of anastomotic fistula is related to the surgical method and approach. The incidence of cervical anastomotic fistula is higher than that of intrathoracic anastomotic fistula; the incidence of esophageal gastric anastomotic fistula is lower than that of esophageal intestinal blown fistula. The causes of its occurrence are mainly related to surgical techniques, whether there is tension at the anastomosis, whether there is secondary infection at the anastomosis, and the nutritional status of the patient before surgery. Anastomotic fistula often occurs 4-6 days after surgery, but it can also occur as late as 10 days or later after surgery. If anastomotic fistula occurs in the chest, there may be symptoms such as increased body temperature, increased heart rate, chest pain and difficulty breathing. In severe cases, there may be symptoms of shock such as pale complexion, sweating, weak pulse, irritability or indifference. However, cervical anastomotic fistula is mostly manifested as low fever, and gas, saliva or food residues overflow from the neck wound. Generally, most cervical anastomotic fistulas can heal after incision and drainage. Intrathoracic anastomotic leakage should be treated with closed chest drainage, re-open chest anastomosis, anastomotic leakage repair and esophageal externalization according to the patient's physical condition, the time of occurrence of the anastomotic leakage, the original anastomotic method, etc. At the same time, the patient should be given adequate nutrition and maintain water and electrolyte balance.

3. Simple empyema: Simple empyema refers to empyema that occurs in the absence of anastomotic leakage. Since bacteria exist in the esophageal cavity under normal circumstances, esophageal surgery is a contaminated surgery and empyema may occur after surgery. The prevention method is to strictly distinguish between sterile and aseptic operation steps during surgery, change dressings and instruments in time, and flush the chest cavity. Keep the chest drainage tube unobstructed after surgery. Once empyema is found, closed chest drainage should be performed in time, which is also a complication of esophageal cancer.

4. Anastomotic stenosis: Generally, anastomotic stenosis refers to anastomotic diameter less than 1 cm. It is another complication after esophageal cancer surgery. Patients will have varying degrees of dysphagia. Postoperative anastomotic stenosis usually occurs 2 to 3 weeks after surgery, and dysphagia may occur as late as 2 to 3 months after surgery. It is often related to factors such as anastomotic technique, anastomotic infection, anastomotic fistula, and the patient's own scar constitution. If anastomotic stenosis is confirmed by examination, esophageal dilation can be performed, which can usually be cured. For a small number of patients who fail esophageal dilation, esophageal stenting, resection of the anastomotic stenosis, and re-anastomosis can be performed. This is also a complication of esophageal cancer.

The above is a brief introduction to the complications of esophageal cancer. What do you think after reading it? I hope that when making a choice, you must carry out treatment based on your actual situation. Only in this way can the best results be achieved.