Carney Adam, Dickinson Matt
Department of Anaesthesia, Nottingham University Hospitals NHS Trust, City Campus, Hucknall Road, Nottingham NG5 1PB, UK.
Department of Anaesthesia, Perioperative Medicine and Pain, Royal Surrey County Hospital NHS Foundation Trust, Egerton Road, Guildford, Surrey GU2 7XX, UK.
Anesthesiol Clin. 2015 Mar;33(1):143-63. doi: 10.1016/j.anclin.2014.11.009. Epub 2014 Dec 31.
Esophagectomy is a high-risk operation with significant perioperative morbidity and mortality. Attention to detail in many areas of perioperative management should lead to an aggregation of marginal gains and improvement in postoperative outcome. This review addresses preoperative assessment and patient selection, perioperative care (focusing on pulmonary prehabilitation, ventilation strategies, goal-directed fluid therapy, analgesia, and cardiovascular complications), minimally invasive surgery, and current evidence for enhanced recovery in esophagectomy.
食管切除术是一种高风险手术，围手术期发病率和死亡率都很高。在围手术期管理的许多方面注重细节应能带来微小收益的累积，并改善术后结果。本综述探讨了术前评估和患者选择、围手术期护理（重点关注肺部预康复、通气策略、目标导向液体治疗、镇痛和心血管并发症）、微创手术以及食管切除术中促进康复的现有证据。
