ABSTRACT
Postop It is not necessary to use a nasogastric tube. Oral intake of liquids and soft foods
(with no red meat or dry bread) is begun as soon as the patient has no nausea, usu ally on the day of surgery. Pain is controlled with injectable ketorolac +/- narcotics for 6-12 hours and then oral pain medicine. If intraoperative esophageal perforation occurred (5% chance), the patient is kept NPO and a water-soluble-contrast X-ray swallow is performed the following morning; if there are no signs of leakage, PO fluids are begun. If leakage is noted, the patient should be monitored closely for clinical signs of esophageal perforation (fever, vital sign changes suggesting sepsis, breathing difficulties, chest pain, subcutaneous emphysema) and a thoracic surgeon consulted. If there are no clinical signs of esophageal perforation, the patient is kept NPO and a repeat water-soluble-contrast X-ray swallow performed in 5-7 days.
