Esophageal cancer surgery: 'poor outcomes' with certain symptoms
If the entire esophagus is removed, the surgeon may create a new passage in the chest for food to pass through into the rest of the gastrointestinal tract using the bowel or stomach. Several different approaches can be used, with incisions required in the neck, chest, or abdomen. Often the surgeon will begin with a "mini" operation on the abdomen to ensure no cancer has spread there. Occasionally, some parts of the procedure can be performed by inserting a thin tube with a light on the end into either the abdomen (laparoscopy) or chest area (thoracoscopy). The use of laparoscopy and thoracoscopy can help minimize the side effects after the operation. In rare cases, for cancers very high in the esophagus (near the mouth or throat), surgery requires the removal of the structures in the neck, such as the voice box. Swallowing might be difficult following the surgery, and reflux is often a problem. At first, the diet should be liquid, and then should progress to soft foods.
The investigators say that surgery for esophageal cancer can cause severe post-operative symptoms for patients that can affect their quality of life. Symptoms include problems eating and swallowing, reflux, pain and fatigue. Previous research looking at symptoms of other cancers has revealed that patients may experience symptoms in specific groupings, and that these groupings could determine patient outcomes. To see whether this is the case for esophageal cancer, the investigators analyzed 402 patients who underwent surgery for the condition. Three different symptom groups discovered From their analysis, the researchers found that patients experienced specific symptoms that "clustered" together into three separate groups 6 months after surgery. These groups were divided into symptoms related to: Reflux and cough Eating difficulties. The investigators found that patients who experienced symptoms relating to reflux and cough, as well as eating difficulties, were more likely to die from esophageal cancer, compared with patients who did not experience these symptom groups. Dr.
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