Post oesophagectomy surgical complications - mediastinitis

My husband, Russ, had his surgery for T3N1 adenocarcinoma on 23 July and then underwent the usual X-rays and scans to ensure that healing had taken place before he started eating and drinking and all looked fine. However, ten days later collapsed with mediastinitis, sepsis and multi organ failure requiring life saving surgery. Surgeons couldn't find any evidence of a leak or "pop" or the cause of what could have caused the infection and sepsis which was very frustrating. Russ spent over three weeks in intensive care, most of it on ventilation and is now on a ward trying to recover. Eating and drinking is being resumed again although he is very apprehensive about it which is only natural. His surgeons and critical care team call him "Miracle Man" as he was not meant to survive such a catastrophic complication. I'm just wondering if anyone else has experienced a similar fate and how long it took to regain some strength. It only goes to show, that you must never give up whatever this dreadful cancer throws your way.

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  • I'm sorry to hear of your husband's problems. My story is similar, if not so severe.

    Three years ago I had an oesophagectomy for T1 adenocarcinoma. For the first five days I was recovering as expected, then things began to go wrong. I had sudden severe pain in my abdomen, and an endoscopy showed I had a perforated duodenal ulcer, with subphrenic abcesses. I then developed pneumonia, and spent 11 days on a ventilator in ICU. I was two months in hospital. It took more than a year to recover.

    It will take Russ a long time to recover, it's a very slow process, but he's made a good start, he's out of ICU and onto a ward. I hated ICU, it gave me nightmares that I can still remember after all this time.

  • Thanks for your reply Patchworker!! Russ is hopefully, going to a rehabilitation centre for a couple of weeks during the next few days to regain his strength so that is a positive step in the right direction! Fortunately Russ has not suffered nightmares after his stint in ICU but we have heard of many people that do. Russ is taking part in some new research about post traumatic stress after ICU and the doctors, nurses and care workers have been keeping a daily diary about his journey through ICU and his time on the the ward. We are also encouraged to write in the diary too and once Russ is recovering well, he will be invited back to the hospital to join a post-ICU support group and also visit the unit, see where he spent those lost days and meet the people who cared for him. He will also see a counsellor who will go through his diary with him and help him over any psychological difficulties he has. So all good stuff! Keep well yourself.

  • I had a similar experience to Russ following oesophagus cancer op. I came out of hospital after more than six weeks still very weak, unable to walk unaided and four stone lighter, this was almost three years ago just before my seventy-first birthday. After six months I went on holiday to Portugal with my family, and after a year I resumed playing golf off a slightly higher handicap which incidently enabled me to become a winner once again, every cloud has a silver lining. My biggest problem in the first few months was indigestion which was solved firstly by taking omeprazole and subsequently.lanzoprazole. I'm still four stone lighter than before the op.but feel absolutely fine. Recovery is a long job and I would say it is about a year before one can really consider oneself near normal again.

  • Thank you for that positive news Graham. Russ is also a golfer so we are hoping he will be able to pick up his clubs again by next summer. He has been in hospital for seven weeks now and during the next few days he will be going to a rehabilitation centre for a couple of weeks to regain his strength - considering we were told he would not recover from the second operation, he is doing amazingly well!

  • My surgery was not for cancer, but I had a ruptured oesophagus which created a lot of infection in my chest, and the first repair had to be re-done. It does take a surprisingly long time for the infection and after-effects to clear. The surgical repairs sometimes do take a long time to become 'leak proof'. It is an enormous challenge to have the patience and stamina to get over it all, but gradually, over the months, it does get slowly better. Gentle exercise gradually increasing is very therapeutic - and do not be surprised if the trial and error process lets you overdo things every so often.

    I had my trouble in February 2001 and refereed a football match in the November, but I did not have the complications of re-plumbed digestion. It was about three years before my wife told me I no longer wheezed when walking up hills.

    So if Russ does not feel better as quickly as he would like, it is likely to be the slow recovery rather than any problems with the cancer treatment.

    I have suddenly realised that I now have an excuse for my poor golf shots - but as my surgery was so long ago I do not think anybody would really take it seriously.

  • Thank you Alan for such encouraging comments. After seven weeks spent in ICU and on the digestive diseases ward of a major trauma hospital, Russ has now been moved to our local, cottage hospital for some rest, recuperation and rehabilitation and to be looked after by our much loved GP. He has blossomed over the past few days since he has been there and is looking a lot better. We know there is a long, long road ahead but Russ is determined to get back on the golf course within the year. I don't think Russ will be able to have the post operative three rounds of chemo as he is much too poorly but as the pre-operative chemo didn't shrink the tumour at all, then maybe it's not so important. But Russ has survived the most catastrophic complication of an oesophagectomy and that's all that matters and the family can be happy and enjoy the moment.

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