Kikuchi Hirotoshi, Booka Eisuke, Hiramatsu Yoshihiro, Takeuchi Hiroya
Department of Surgery Hamamatsu University School of Medicine Hamamatsu Japan.
Department of Perioperative Functioning Care and Support Hamamatsu University School of Medicine Hamamatsu Japan.
Ann Gastroenterol Surg. 2024 Jul 29;8(6):966-976. doi: 10.1002/ags3.12847. eCollection 2024 Nov.
In the era of minimally invasive surgery, esophagectomy remains a highly invasive procedure with a high rate of postoperative complications. Preoperative risk assessment is essential for planning esophagectomy in patients with esophageal cancer, and it is crucial to implement evidence-based perioperative management to mitigate these risks. Perioperative support from multidisciplinary teams has recently been reported to improve the perioperative nutritional status and long-term survival of patients undergoing esophagectomy. Intraoperative management of anesthesia and fluid therapy also significantly affects short-term outcomes after esophagectomy. In this narrative review, we outline the recent updates in the perioperative management of esophagectomy, focusing on preoperative risk assessment, intraoperative management, and perioperative support by multidisciplinary teams to improve operative outcomes.
在微创手术时代,食管切除术仍然是一种高侵入性手术,术后并发症发生率很高。术前风险评估对于规划食管癌患者的食管切除术至关重要,实施基于证据的围手术期管理以降低这些风险也至关重要。最近有报道称,多学科团队的围手术期支持可改善接受食管切除术患者的围手术期营养状况和长期生存率。食管切除术术中的麻醉管理和液体治疗也显著影响短期预后。在这篇叙述性综述中,我们概述了食管切除术围手术期管理的最新进展,重点关注术前风险评估、术中管理以及多学科团队的围手术期支持,以改善手术效果。