There is a risk of problems or complications after any operation.
Possible problems after oesophageal cancer surgery include difficulty eating, or a leak where the surgeon joins the oesophagus to the stomach or the bowel. Other risks include infection, blood clots and bleeding.
Many problems are minor but some can be life threatening. Treating them as soon as possible is important.
Weakness and lacking in strength
Surgery for oesophageal cancer is a major operation.
Most people feel weak and lack strength for some time afterwards. How long this lasts varies between people.
Tell your doctor or nurse if the weakness continues for more than a few weeks. They can suggest things to help, such as physiotherapy.
Most people have some problems eating after surgery. This can cause weight loss. You’ll usually be able to eat normally again in a few months. For some people it takes up to 2 years. And there might be some foods you will always need to avoid.
You might also have tummy (abdominal) discomfort and diarrhoea after certain foods. The combination of these symptoms is called dumping syndrome.
Eating small amounts regularly is important. Tell your dietitian about any problems you have with eating.
Leaks can happen where the surgeon joins the oesophagus to the stomach or the bowel. This is called an anastomotic leak. This is a serious problem and you need to have treatment straight away.
- stopping eating and drinking
- draining the leak
- tube feeding
You will have endoscopies and scans to check that it is healing. You might need more surgery to repair the leak if the other treatments don’t work. You need to stay in hospital longer if you have a leak.
Around 6 out of 100 people (6%) have a leak after this surgery. This is most likely to happen in the first week after surgery. It is extremely rare for people to have a leak after they have gone home.
Contact your doctor if you have any breathlessness or severe chest pain.
Some people have heart problems after this surgery. This can cause problems with other organs, including your kidneys. You’ll have regular blood tests to check how well your heart and kidneys work.
You may have voice changes after your operation, including hoarseness. This happens if the nerve that connects to the voicebox is damaged during your operation.
This is usually temporary because of bruising. More rarely it can be permanent. Even more rarely people need surgery to repair their vocal cords.
Slow emptying of your stomach and reflux
Surgery can cause a problem with the contents of the stomach going back into the oesophagus (reflux).
Reflux can cause symptoms such as heartburn. Treatment includes
- medicines that help to move food through the stomach and bowel
Thoracic duct or chyle leak
The thoracic duct is a tube close to the oesophagus. It is part of the lymphatic system. During your operation, your surgeon may divide it. Rarely, it leaks after your operation. This is most likely to happen in the first week after surgery.
The main symptom is more fluid draining into your chest drain than your doctor would expect.
Rarer symptoms include pain and feeling breathless.
Treatment is to drain the fluid. You might need to have another tube put into the area where the fluid is collecting. You might need to have an operation to repair it if the duct doesn’t repair itself.
Contact your doctor if you have any symptoms.
After any major operation there is a risk of:
You are at risk of getting an infection after an operation, such as a wound, chest or urine infection. Tell your doctor or nurse if you have any symptoms of infection.
- a high temperature
- feeling hot and cold
- feeling generally unwell
- feeling sick
- swelling or redness around your wound
Your doctor can give you antibiotics. Occasionally for an infection in your wound or pelvis, you may need another operation.
Blood clots (deep vein thrombosis, DVT) are a possible complication of having surgery because you might not move about as much as usual. Clots can block the normal flow of blood through the veins. Let your doctor or nurse know if you have an area in your leg that is swollen, hot, red or sore.
There is a risk that a blood clot can become loose and travel through the bloodstream to the lungs, causing a blockage there (a pulmonary embolism). Symptoms include:
- shortness of breath
- chest pain
- coughing up blood
- feeling dizzy or light headed
To prevent clots it's important to do the leg exercises that you were taught by your nurse or physiotherapist. Your nurse might also give you an injection just under the skin to help lower the risk whilst you are in hospital. You might need to carry on having these injections for 4 weeks, even after you go home. This depends on the type of operation you had.
Your nurse might teach you to do these injections yourself before you go home. Or a district nurse might come to your home to do them.
It's important to continue wearing compression stockings if you have been told to by your doctor.
There is a risk that you will bleed after your operation. The team looking after you will monitor you closely for signs of bleeding. The treatment you need depends on what is causing the bleeding and how much blood you lose. You might need a blood transfusion.
Chest and breathing problems
Chest infections, including pneumonia, can be serious.
You can lower your risk by:
- stopping smoking before your operation
- getting up and moving as soon as possible after your operation
- doing any breathing exercises your physiotherapist teaches you
If you get an infection you have antibiotics to treat it.