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食管癌食管切除术患者围手术期管理的最新进展

Recent progress in perioperative management of patients undergoing esophagectomy for esophageal cancer.

作者信息

Watanabe Masayuki, Okamura Akihiko, Toihata Tasuku, Yamashita Kotaro, Yuda Masami, Hayami Masaru, Fukudome Ian, Imamura Yu, Mine Shinji

机构信息

Esophageal Cancer Division, Department of Gastroenterological Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan.

出版信息

Esophagus. 2018 Jul;15(3):160-164. doi: 10.1007/s10388-018-0617-9. Epub 2018 Apr 25.

Abstract

Esophagectomy remains the mainstay of curative intent treatment for esophageal cancer. Oncologic esophagectomy is a highly invasive surgery and both morbidity and mortality rates still remain high. Recently, it has been revealed that multidisciplinary perioperative management can decrease the postoperative complications after esophagectomy. In this review, we summarized the recent progress in each component of multidisciplinary perioperative care bundle, including oral hygiene, cessation of smoking and alcohol, respiratory training, measurement of physical fitness, swallowing evaluation and rehabilitation, nutritional support, pain control and management of delirium. The accumulation of evidence and the popularization of knowledge will increase safety of esophagectomy and thus improve the outcome of patients with esophageal cancer.

摘要

食管癌切除术仍然是食管癌根治性治疗的主要手段。肿瘤性食管癌切除术是一种高侵入性手术,其发病率和死亡率仍然很高。最近,有研究表明,多学科围手术期管理可以降低食管癌切除术后的并发症。在本综述中,我们总结了多学科围手术期护理方案各组成部分的最新进展,包括口腔卫生、戒烟戒酒、呼吸训练、体能测量、吞咽评估与康复、营养支持、疼痛控制和谵妄管理。证据的积累和知识的普及将提高食管癌切除术的安全性,从而改善食管癌患者的治疗效果。

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