Congedo Elisabetta, Aceto Paola, Petrucci Rosanna, Mascia Antonio, Gualtieri Elisabetta, De Cosmo Germano
Istituto di Anestesiologia e Rianimazione, Università Cattolica del Sacro Cuore, Policlinico A. Gemelli, Roma.
Rays. 2005 Oct-Dec;30(4):341-5.
Esophagectomy for carcinoma of the esophagus is associated with significant mortality and morbidity. Patients with esophageal cancer have frequently obstruction with dysphagia and they often develop malnutrition. In addition, patients can suffer from chronic aspiration leading to a poor preoperative respiratory status. Thorough preoperative evaluation is essential for assessing the operative risk in the individual patient. Respiratory and cardiac problems are the most common complications and assessment of surgical risk, preoperative performance status, particularly with regard to pulmonary and cardiac risk, is likely to be the most important factor. Clinical findings are more predictive of pulmonary complications than results of testing. Cardiac risk is evaluated according to the American College of Cardiology (ACC)/American Heart Association guidelines. With the identification of risk factors, patients undergoing esophageal surgery could be stratified. Appropriate preoperative risk-reduction strategies can be used to decrease morbidity and mortality rates associated with esophagectomy for cancer.
食管癌切除术伴随着显著的死亡率和发病率。食管癌患者常因吞咽困难而出现梗阻，且常发生营养不良。此外，患者可能会因慢性误吸导致术前呼吸状态不佳。全面的术前评估对于评估个体患者的手术风险至关重要。呼吸和心脏问题是最常见的并发症，评估手术风险、术前身体状况，尤其是肺部和心脏风险，可能是最重要的因素。临床发现比检查结果更能预测肺部并发症。心脏风险根据美国心脏病学会（ACC）/美国心脏协会指南进行评估。通过识别风险因素，可以对接受食管手术的患者进行分层。可以采用适当的术前风险降低策略来降低与食管癌切除术相关的发病率和死亡率。
