After your operation for oesophageal cancer

When you wake up after your operation

After a big operation, you usually wake up in the intensive care unit. You move back to the ward within a few days.

In intensive care you have one to one nursing care. Your surgeon and anaesthetist review you regularly and watch your progress closely.

These units are busy and often noisy places that some people find strange and disorientating. You'll feel drowsy because of the anaesthetic and painkillers.

It's common for people to have strange dreams or hallucinations during and after a stay in intensive care. These can seem very real and frightening. They usually get better with time but do talk to your hospital team if they continue.

Tubes and drains

When you wake up, you’ll have several tubes in you. This can be frightening, so it helps to know what they’re for.

You might have:

• drips to give you blood transfusions and fluids usually through a vein in your neck

• wound drains to drain any blood or fluid

• a chest drain to help your lung expand again

• a tube into your bladder (catheter) to measure how much urine you pass

• a small tube into a vein or artery to check your blood pressure

• a fine tube into your back that goes into your spinal fluid (epidural) to help relieve pain

• a tube down your nose into your stomach (nasogastric tube) to drain bile and stop you feeling sick

You may also have an oxygen mask on.

Electronic pumps may control any medicines you have through your drip.

Painkillers

It’s normal to have pain for the first week or so. You have painkillers to help.

Tell your doctor or nurse as soon as you feel any pain. They need your help to find the right type and dose of painkiller for you. Painkillers work best when you take them regularly.

Immediately after surgery you might have painkillers through a drip into the bloodstream that you control. This is called patient controlled analgesia (PCA). Analgesia is another word for painkillers. 

Or you might have painkillers through a small thin tube that is put into your back. This tube connects to a pump that gives you a constant dose of painkillers. This is called an epidural.

You get painkillers to take home. Your nurse will talk to you about:

• how often to take them

• when to take them

• what side effects you may get 

Contact your doctor if you still have pain or if it gets worse.

Your wound

You have dressings over your wounds. The position and number of wounds you have depend on what type of surgery you have.

Most people have 2 wounds after open surgery.  You might have 5 or 6 smaller wounds after keyhole surgery.

To close your wound you might have stitches or clips. The stitches might be dissolvable and the surgeon might also use steristrips. Your nurse will check the dressing to see if the wound needs cleaning. Try to keep your dressings dry.

Your stitches or clips stay in for at least 10 days. The nurse usually takes them out before you go home if they aren't dissolvable stitches. You can go home with the stitches in if your wound is still healing and you are otherwise well. The practice nurse, district nurse or hospital nurse then takes them out. This might be at home or you may need to go back to the hospital.

Before you go home the nurse gives you information about how to care for the wound.

Eating and drinking

Immediately after surgery you can’t eat or drink. You have fluids through a drip. When you can start to drink again, begin with sips of water. This is usually within 24 to 48 hours. Your doctor might ask for a special x-ray before you start eating or drinking.

You gradually build up what you drink and eat. Most people are able to eat small amounts within a week or so.

Some people need a feeding tube to help them maintain their nutrition. The tube can go into the small bowel or into a vein (a drip).

You see the dietitian most days while you are in hospital. You can contact them once you get home if you have any problems.

Getting up

Your nurses and physiotherapists help you to move around as soon as possible. They check you’re doing your breathing and leg exercises. This helps you recover.

You might be sitting in a chair within 12 hours of your operation. The day after, you’ll be walking around your bed. And within a few days you’ll be able to walk along the hospital corridor.

Making progress

During the first few days after your operation you’ll start to feel better. The drips and drains come out, you start eating and can move about better.

You’ll begin to feel that you’re making progress. Most people go home about 10 to 14 days after the operation.

Going home

You’ll need help when you first go home. The dietitian will talk to you and your family about what to eat. It can take some time to find what works for you.

You’re likely to feel very tired for several weeks and sometimes months after your surgery. You will need to take plenty of time to rest at first.

It helps to do a bit more every day. Try:

• sitting for less time each day

• walking around the house a bit more each day

• building up to walking outside

What you can do depends on how fit you were before your surgery and any problems you have afterwards. Talk to the physiotherapist or your doctor if you’re unsure about what you should be doing.

Contact your doctor or specialist nurse if you have any problems or symptoms you are unsure about. You’ll have follow up appointments to check your recovery and sort out any problems. They‘re also your opportunity to raise any concerns you have about your progress.

Find out about possible problems after surgery