Blog

Swallowing problem returned after esophageal cancer surgery” Is it over?

65 years male resident of Chandigarh had difficulty in swallowing at presentation, diagnosed as cancer of esophagus, underwent esophagectomy about a year ago. Six months later he developed difficulty in swallowing again which was a mental trauma to him as if all his medical treatment so far has gone in vain and feared that the tumor have possibly come back. UGI endoscopy showed narrowing at the surgically created food pipe and was advised endoscopic dilatation at his local place but the misery continued even after multiple attempts.

 

Walkthrough

Esophageal cancer causes blockage of food pipe causing difficulty to swallow and esophagectomy is the only option promises to cure it. During surgery the diseased esophagus is removed and replaced with stomach as a new food pipe. Replacing what nature has given us is not a commodity human possess but as said “medicine is conceived in sympathy and born out of necessity” and stomach is the most suitable replacement for esophagus with some inherent shortcomings like development of stenosis which leads to difficulty in swallowing. Since these problems arise within 2 to 3 months of surgery, late presentation like this arose suspicion of cancer recurrence, hence a PETCT scan was performed to exclude it. Once the disease recurrence was excluded next task was to restore the “right to eat “. In view of previous failures at dilatation, adding another dilatation was bound to fail and would have demoralized the patient. After discussing it with the Gastroenterologist, a metallic stent was placed across the stenosis as a day care UGI endoscopic procedure. Oral diet was resumed immediately which restored patient’s sense of belonging. The stent was removed after 6 weeks without the problem to return. Patient is happy, it is 3 months since then, he can eat normally.

Esophagectomy is a major surgery, bound to shortcomings like anastomotic narrowing leading to difficulty in swallowing to return (5 out of 100 patients) which affects quality of life. Restoration of eating can be achieved by nonsurgical means and the end points can be achieved by a day care procedure.      

Categories: Esophageal Cancer

Tags: Cancer of Esophagus