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食管癌手术:并发症及其处理的综述。

Esophageal cancer surgery: review of complications and their management.

机构信息

Division of Visceral Surgery, Department of Surgery, Geneva University Hospital, Geneva, Switzerland.

Department of General, Visceral, Cancer and Transplantation Surgery, University Hospital of Cologne, Cologne, Germany.

出版信息

Ann N Y Acad Sci. 2020 Dec;1482(1):146-162. doi: 10.1111/nyas.14492. Epub 2020 Sep 15.

Abstract

Esophagectomy, even with the progress in surgical technique and perioperative management, is a highly specialized surgery, associated with a high rate of complications. Early recognition and adequate treatment should be a standard of care for the most common postoperative complications: anastomotic leakage, pneumonia, atrial fibrillation, chylothorax, and recurrent laryngeal nerve palsy. Recent progress in endoscopy with vacuum and stent placement, or in radiology with embolization, has changed the management of these complications. The success of nonoperative treatments should be frequently reassessed and reoperation must be proposed in case of failure. We have summarized the clinical signs, diagnostic process, and management of the frequent complications after esophagectomy for esophageal cancer.

摘要

食管切除术,即使在手术技术和围手术期管理方面取得了进展,仍然是一种高度专业化的手术,其并发症发生率较高。早期识别和充分治疗应该是最常见术后并发症的护理标准:吻合口漏、肺炎、房颤、乳糜胸和喉返神经麻痹。内镜下真空和支架放置或放射学栓塞的最新进展改变了这些并发症的处理方式。非手术治疗的成功率应经常重新评估,如果治疗失败,必须提出再次手术。我们总结了食管癌食管切除术后常见并发症的临床症状、诊断过程和处理方法。

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