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학습 자료 둘러보기 →The highest immediate postoperative risk after esophagectomy with gastric pull-up is aspiration, not anastomotic leak. The surgery destroys the lower esophageal sphincter, placing the intrathoracic stomach under positive pressure, which promotes silent regurgitation.
Maintain the patient in a semi-Fowler's position (head of bed elevated 30-45 degrees) at all times. This uses gravity to keep gastric contents in the conduit and is a continuous preventive measure.
Never place the patient flat or in Trendelenburg position. Monitor respiratory status vigilantly for early signs of aspiration: tachypnea, decreased SpO2, or new-onset crackles. Keep suction equipment at the bedside and verify NG tube patency and placement per order, but never manipulate or irrigate the NG tube without a specific surgeon's order due to risk of disrupting the fresh anastomosis.
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