I. Preoperative Care
Psychological support: Progressive dysphagia leads to increasing emaciation and diminished confidence in treatment. Psychological counseling, reassurance, and encouragement should be provided according to the patient's mental state.
Nutritional support: For patients still able to eat, a liquid or semi-liquid diet high in calories, protein, and vitamins should be given. For those unable to eat, fluids, electrolytes, and calories should be supplemented intravenously. Patients with hypoproteinemia should receive blood or plasma protein transfusions as needed.
Gastrointestinal preparation: Oral hygiene should be maintained. A nasogastric tube and a duodenal drip tube should be inserted preoperatively. Preoperative fasting is required; for patients with food retention, isotonic saline esophageal irrigation should be performed the evening before surgery.
Preoperative training: Patients should be taught deep breathing, effective coughing, expectoration, and in-bed defecation.
II. Postoperative Care
Maintain patency of the gastrointestinal decompression tube: Keep in place for 3–5 days to reduce tension on the anastomotic site.
Closely monitor chest drainage output and characteristics: Be alert for active bleeding, anastomotic leakage, or chylothorax.
Strict dietary control: Strict fasting and fluid restriction should be maintained postoperatively. On postoperative day 5, oral intake of milk may be initiated if no abnormalities are observed. On days 10–12, transition to a residue-free semi-liquid diet.
Monitor for anastomotic leakage: Manifestations include high fever, rapid pulse, dyspnea, and severe chest pain, which require prompt intervention.
III. Dietary Care – A Priority
The prominent symptom in esophageal cancer patients is dysphagia. Special attention should be paid to:
Do not force swallowing when a choking sensation occurs, as this may irritate cancerous tissue, leading to bleeding, spread, and pain.
Avoid consuming cold liquids, as cold stimulation tends to induce esophageal spasm, nausea, and vomiting.
Avoid spicy, pungent, or foul-smelling foods.
During treatment, a bland, nutritionally rich, and easily digestible diet is recommended. During treatment intervals, foods that nourish blood, enrich vital energy, and strengthen the body are encouraged.
IV. Prevention Strategies – Three-Tier Prevention
Primary prevention (etiological intervention):
Avoid consuming moldy or spoiled foods (aflatoxins are potent carcinogens).
Avoid overheated or scalding foods (≥65°C is classified as Group 2A carcinogen); tea and porridge are best consumed below 50°C.
Reduce intake of pickled vegetables and cured meats containing nitrites.
Refrain from smoking and consuming strong alcohol (their combined carcinogenic effect is synergistic and significantly increased).
Consume more fresh vegetables and fruits to increase vitamin C intake.
Prevent water source contamination and improve water quality.
Supplement essential trace elements as needed.
Secondary prevention (early detection and treatment):
Residents in high-incidence areas should undergo annual esophageal cancer screening.
Seek prompt medical attention if symptoms such as swallowing discomfort, foreign body sensation, or retrosternal discomfort occur.
Individuals aged ≥45 years with high-risk factors should undergo regular gastroscopy.
Tertiary prevention (standardized treatment):
Receive standardized comprehensive treatment as early as possible after diagnosis.
Attend regular follow-up visits to monitor for recurrence and metastasis.
This content is compiled based on the latest medical evidence from 2025–2026 and is for reference purposes only. For specific diagnosis and treatment, please follow the instructions of your physician.