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食管切除术后的功能性综合征和症状导向的康复治疗。

Functional syndromes and symptom-orientated aftercare after esophagectomy.

机构信息

Department of Visceral and Transplant Surgery, University Hospital Zurich, Zurich, Switzerland.

Department of General, Visceral, Endocrine and Transplant Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland.

出版信息

Langenbecks Arch Surg. 2021 Nov;406(7):2249-2261. doi: 10.1007/s00423-021-02203-y. Epub 2021 May 25.

Abstract

BACKGROUND

Surgery is the cornerstone of esophageal cancer treatment but remains burdened with significant postoperative changes of gastrointestinal function and quality of life.

PURPOSE

The aim of this narrative review is to assess and summarize the current knowledge on postoperative functional syndromes and quality of life after esophagectomy for cancer, and to provide orientation for the reader in the challenging field of functional aftercare.

CONCLUSIONS

Post-esophagectomy syndromes include various conditions such as dysphagia, reflux, delayed gastric emptying, dumping syndrome, weight loss, and chronic diarrhea. Clinical pictures and individual expressions are highly variable and may be extremely distressing for those affected. Therefore, in addition to a mostly well-coordinated oncological follow-up, we strongly emphasize the need for regular monitoring of physical well-being and gastrointestinal function. The prerequisite for an effective functional aftercare covering the whole spectrum of postoperative syndromes is a comprehensive knowledge of the pathophysiological background. As functional conditions often require a complex diagnostic workup and long-term therapy, close interdisciplinary cooperation with radiologists, gastroenterologists, oncologists, and specialized nutritional counseling is imperative for successful management.

摘要

背景

手术是食管癌治疗的基石,但仍存在胃肠道功能和生活质量的显著术后改变。

目的

本综述旨在评估和总结食管癌手术后功能性综合征和生活质量的现有知识,并为读者在功能康复这一具有挑战性的领域提供指导。

结论

食管切除术后综合征包括各种病症,如吞咽困难、反流、胃排空延迟、倾倒综合征、体重减轻和慢性腹泻。临床表现和个体表现高度可变,可能对受影响者造成极大困扰。因此,除了进行协调良好的肿瘤学随访外,我们强烈强调需要定期监测身体舒适度和胃肠道功能。涵盖所有术后综合征的有效功能康复的前提是对病理生理学背景的全面了解。由于功能性病症通常需要复杂的诊断和长期治疗,因此与放射科医生、胃肠病学家、肿瘤学家和专门的营养咨询密切的跨学科合作对于成功管理至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5627/8578083/00ec7a025bf4/423_2021_2203_Fig1_HTML.jpg

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