Fumagalli Romario Uberto, de Pascale Stefano
Digestive Surgery, European Institute of Oncology IRCCS, Milan, Italy.
Updates Surg. 2023 Feb;75(2):343-355. doi: 10.1007/s13304-022-01332-3. Epub 2022 Jul 18.
Esophagectomy still remains the mainstay of treatment for localized esophageal cancer. Many progresses have been made in the technique of esophagectomy in the last decades but the overall morbidity for this operation remains formidable. Postoperative complication and mortality rate after esophagectomy are significant; anastomotic leak has an incidence of 11,4%. The occurrence of a complication is a significant negative prognostic factor for long term survival and is also linked to longer postoperative stay, a lower quality of life, increased hospital costs. Preventing the occurrence of postoperative morbidity and reducing associated postoperative mortality rate is a major goal for surgeons experienced in resective esophageal surgery. Many details of pre, intra and postoperative care for patients undergoing esophagectomy need to be shared among the professionals taking care of these patients (oncologists, dieticians, physiotherapists, surgeons, nurses, anesthesiologists, gastroenterologists) in order to improve the short and long term clinical results.
食管癌切除术仍然是局限性食管癌治疗的主要手段。在过去几十年里,食管癌切除技术取得了许多进展,但该手术的总体发病率仍然很高。食管癌切除术后的并发症和死亡率很高;吻合口漏的发生率为11.4%。并发症的发生是长期生存的一个重要负面预后因素,也与术后住院时间延长、生活质量降低、医院成本增加有关。预防术后发病的发生并降低相关的术后死亡率是经验丰富的食管切除手术外科医生的主要目标。为了改善短期和长期临床结果,需要在照顾这些患者的专业人员(肿瘤学家、营养师、物理治疗师、外科医生、护士、麻醉师、胃肠病学家)之间分享食管癌切除患者术前、术中和术后护理的许多细节。