What is an Oesophagectomy
I had a two stage robotic assistited Oesophagectomy. Oesophagectomy is a surgical procedure to remove some or all of the tube connecting the mouth to the stomach, called the oesophagus. The oesophogus is then reconstructed using part of another organ, in my case was the stomach. 2/3’s of the oesophagus was removed and 1/3 of my stomach removed during my procedure.
The procedure is commonly used for a condition known as Barrett Oesophagus if precancerous cells are present. This is what I had, for many years.
The diagram below shows the state of my cancer in my body.
The procedure involved removing two thirds of the original oesophagus and part of my stomach impacted by the cancer, and all lymph nodes. The stomach is then stretched up to form the new oesophagus. The whole procedure used a robot assisted and through keyhole. I have a number of holes across my abdomen, and drain holes down my side, and a large incision in the back of the chest to remove the impacted organs.
Living with a new stomach
The first thing to note that as I don’t have an oesophagus food and stomach acids can freely move up in to the throat and out my mouth. So laying on a flat bed with just a pillow is not going to be suffice. I have to have a ‘wedge’ type pillow to raise my upper body for fluids and food to remain in.
Food intake is massively impacted. Little and often, is a term that is used a lot. I have to eat a small amount of food, often throughout my day. I will no longer have a breakfast, lunch, dinner diet. The portions have to be small, so that the stomach does not balloon up in my chest and crush my lungs, so we are looking at starters, or small side plate portions per sitting. I then have to wait at least an hour for that food to clear the stomach in to the upper intestines for digestion. The smaller the food pieces the less work the stomach will have to do.
Then an hour later, I will repeat the portion. So during the waking day, I should be eating every 2-3 hours small portions of food.
Phase 1 – puree
From dischrage from hospital, I’m on free fluids (anything liquid form) and puree’d food, which is anything that has not got large bits in it. Soups are generally a good source here. This will be for 2-3 weeks or longer so that the gut and stomach can get use to processing food.
Phase 2 – small food
Once the dietitians are happy with the progress of phase 1, I move on to things like scrambled egg, small pasta etc, and starting to introduce solids in to the gut and stomach. This will be for 2-3 months.
Phase 3 – normal food
This phase hasn’t really been discussed with me in too much detail. But it will be normal meals and foods, but items chopped up in small chunks.
Diet
I have to make the most of each food sitting. I need high calories and protein. I will have supplements for vitamins and minerals to my diet. Therefore my diet is typically opposite to the healthy diet. High fat content, loaded calories etc. So, chocolate, cake, double-cream, full fat milk are examples of these. I need to avoid fluids during meals as that takes up precious space for food in the stomach.
Prognosis
My stomach should last me the rest of my life. However, if I overfeed it and it stretches, food will remain in the stomach and cause me a lot of pain and discomfort, and potential surgery will be required to rectify it.
Alcohol is fine, but again in small portions, so no more pints.