Teixeira Farinha Hugo, Bouriez Damien, Grimaud Thomas, Rotariu Ana-Maria, Collet Denis, Mantziari Styliani, Gronnier Caroline
Oeso-Gastric Surgery Unit, Department of Digestive Surgery, Magellan Center, Bordeaux University Hospital, 33600 Pessac, France.
Department of Visceral Surgery, University Hospital of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland.
Cancers (Basel). 2023 Jul 9;15(14):3554. doi: 10.3390/cancers15143554.
Primary surgical indications for the esophagus and stomach mainly involve cancer surgeries. In recent years, significant progress has been made in the field of esogastric surgery, driven by advancements in surgical techniques and improvements in perioperative care. The rate of resectability has increased, and surgical strategies have evolved to encompass a broader patient population. However, despite a reduction in postoperative mortality and morbidity, malnutrition remains a significant challenge after surgery, leading to weight loss, muscle mass reduction, and deficiencies in essential nutrients due to digestive complications. Malnutrition worsens quality of life and increases the risk of tumor recurrence, significantly affecting prognosis. Nevertheless, the nutritional consequences following surgery are frequently overlooked, mainly due to a lack of awareness regarding their long-term effects on patients who have undergone digestive surgery, extending beyond six months. Micronutrient deficiencies are frequently observed following both partial and total gastrectomy, as anticipated. Surprisingly, these deficiencies appear to be similarly prevalent in patients who have undergone esophagectomy with iron, vitamins A, B1, B12, D, and E deficiencies commonly observed in up to 78.3% of the patients. Recognizing the distinct consequences associated with each type of intervention underscores the importance of implementing preventive measures, early detection, and prompt management.
食管和胃的主要外科手术适应症主要涉及癌症手术。近年来，在手术技术进步和围手术期护理改善的推动下，食管胃外科领域取得了显著进展。可切除率有所提高，手术策略也不断演变，以涵盖更广泛的患者群体。然而，尽管术后死亡率和发病率有所降低，但营养不良仍然是术后的一个重大挑战，由于消化并发症导致体重减轻、肌肉量减少和必需营养素缺乏。营养不良会恶化生活质量并增加肿瘤复发风险，显著影响预后。然而，手术的营养后果常常被忽视，主要是因为缺乏对其对消化手术后超过六个月患者长期影响的认识。正如预期的那样，部分和全胃切除术后经常观察到微量营养素缺乏。令人惊讶的是，这些缺乏在接受食管切除术的患者中似乎同样普遍，铁、维生素A、B1、B12、D和E缺乏在高达78.3%的患者中常见。认识到每种干预措施的不同后果凸显了实施预防措施、早期检测和及时管理的重要性。
