These patients usually present with pain abdomen, gas formation, increased acidity, inability to eat, recurrent vomiting, loss of weight and loss of appetite, anemia, etc. They usually require endoscopy and CT scan to diagnose the disease and based upon which surgery is planned.
It is usually done for benign and cancerous diseases of the esophagus and stomach e.g, hiatus hernia, gastroesophageal reflux, achalasia cardia, cancer of the esophagus and stomach, ulcer of the stomach, etc.
Eaophagus cancer usually present with difficulty in swallowing. Patient may feel stickiness of food after swallowing in chest or throat. Usually difficulty starts with solid foods initially and progress onto liquids also.. majority of these patients also have weight loss due to inability to eat normal diet.
With advancements in surgical techniques and laparoscopy, complication rates of esophageal surgery has decreased considerably. Open surgery is associated with increased risk of pneumonia due to opening of chest and is also associated with increased blood loss. However laparoscopic surgery has decreased these risks considerably. Anastomotic leak has also decreased considerably with increased use of staplers in anastomosis. In effect esophageal surgery has become pretty safe now.
Esophageal surgery can be broadly classified into open and laparoscopic surgery. Laparoscopic surgery has significant less complication rate, however has steep learning curve. So in expert hands laparoscopic esophageal surgery is safest and associated with early recovery
Patients are usually up and moving about with 1 or 2 days after laparoscopic surgery. However due to new joint that is made between esophagus and stomach during surgery oral food introduction is slow and usually take around 5-6 days. Till that time food is given through a tube that is inserted directly into intestine.
For prevention of esophagus cancer ,avoid smoking, alcohol consumption, tobacco chewing and foods that promote reflux of acid from stomach into esophagus- coffee, tea, carbonated beverages, etc.
After surgery patient can eat anything but only has to change style of eating. He has to eat small, dry, well chewed meals in upright position and has to sleep with head end elevated position.
Loss of appetite, loss of weight, bloating, early fullness,nausea, vomiting especially late in a day, low hemoglobin and black stools are commonly seen in patients with stomach cancer. Any of these sign, either in isolation or in combination warrant investigation to rule out stomach cancer.
It depends upon stage. If tumor is in advanced stage then chemotherapy is given first followed by surgery. Surgery remains the mainstay in treatment as well as palliation of symptoms as it provides best quality of life for such patients. Surgery also has become pretty safe as majority of these surgeries are also done laparoscopically.
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