Esophageal cancer: therapeutic approaches and nursing care

Complications of esophageal surgery: role of imaging in diagnosis and treatments

Esophageal surgery is a common and integral component in the management of hiatal hernias, esophageal carcinoma, and esophageal perforation. Understanding the expected postsurgical imaging features of these common esophageal surgeries and postoperative complications is essential. Image-guided intervention can be used to aid the surgeon in the management of many post esophageal surgical complications. We discuss the imaging features of the postoperative esophagus and the use of imaging, including fluoroscopy and computed tomography, in the diagnosis of post esophageal surgical complications and treatment.

Endoscopic palliation of malignant dysphagia

Esophageal cancer is the primary cause of malignant dysphagia, a major cause of morbidity and mortality. In patients with esophageal cancer that is unresectable at the time of diagnosis, palliation is the major goal. Surgical treatment as well as radiation and chemoradiation therapy are traditional approaches for such patients. Endoscopic therapy is useful for patients with poor performance status, those in whom other treatments have failed, and those with tracheoesophageal fistulas. In recent years, self-expanding metal stents have become an important new endoscopic treatment modality for palliation of malignant dysphagia in a wide range of patients. Appropriate patient selection is paramount when a mode of palliation for malignant dysphagia is being selected. Although various treatment options exist for palliation of malignant dysphagia, comparative studies among these modalities are needed.

Nutritional care of surgical oncology patients

OBJECTIVES

To review nutritional management of surgical oncology patients, particularly patients with head and neck cancer and gastrointestinal malignancies.

DATA SOURCES

Professional journal articles, published research findings, and book chapters related to the nutritional management of surgical oncology patients.

CONCLUSIONS

Meeting the nutritional needs of oncology patients is challenging. A multidisciplinary approach to the nutritional management of the surgical oncology patient is essential to ensure comprehensive care and assistance in the recovery process.

IMPLICATIONS FOR NURSING PRACTICE

Nurses need to have an understanding of the impact of both the disease process and surgical intervention on the nutritional needs of oncology patients to improve the quality of care and quality of life for these special populations.