Yoshida Naoya, Harada Kazuto, Iwatsuki Masaaki, Baba Yoshifumi, Baba Hideo
Department of Gastroenterological Surgery Graduate School of Medical Sciences Kumamoto University Kumamoto Japan.
Ann Gastroenterol Surg. 2020 Jun 8;4(5):480-484. doi: 10.1002/ags3.12354. eCollection 2020 Sep.
Pulmonary morbidity is the most common complication after esophagectomy. Importantly, it is the main cause of surgery-related mortality and possibly adversely affects the long-term outcome after surgery in patients with esophageal cancer. There is considerable accumulated evidence on multidisciplinary approaches to reduce post-operative pulmonary morbidity. A comprehensive review of the precautionary measures that have so far been shown to be effective in previous literature is of utmost importance. We herein update and summarize the perioperative and surgical approaches to diminish pulmonary morbidity. Pre-operative smoking cessation, respiratory rehabilitation, maintaining oral hygiene, perioperative nutritional intervention, enforcement of less invasive surgery, perioperative administration of steroid, and total management by a multidisciplinary team could be the key factors contributing to reduction in pulmonary morbidity.
肺部并发症是食管癌切除术后最常见的并发症。重要的是，它是手术相关死亡的主要原因，并且可能对食管癌患者的术后长期预后产生不利影响。关于降低术后肺部并发症的多学科方法，已有大量累积证据。全面回顾迄今在以往文献中已证明有效的预防措施至关重要。我们在此更新并总结减少肺部并发症的围手术期和手术方法。术前戒烟、呼吸康复、保持口腔卫生、围手术期营养干预、实施微创手术、围手术期给予类固醇以及多学科团队的全面管理可能是有助于降低肺部并发症的关键因素。
