Murata A, Shiozaki H
Department of Surgery 2, Osaka University Medical School, Japan.
Nihon Geka Gakkai Zasshi. 1996 Jun;97(6):398-403.
Surgical stress against esophageal cancer is quite heavy, because such a patient is usually old and is hyponutrionized due to inadequate peroral intake, as well as suffered from advanced stage of cancer. Thus, the patient suffering from esophageal cancer should have already various degrees of cardiac, pulmonary, or renal dysfunctions preoperatively. From this point of view, we must take care of such patients very carefully, and sometimes make a decision of the decrease of the radicality in surgery. This part describes the management of preoperative complications with cardiac, pulmonary, and renal dysfunction. Such complications must be treated before radical surgery, and be assessed by cardiologists, pulmonary physicians, and anesthesiologists.
食管癌手术应激相当大,因为这类患者通常年事已高,经口摄入量不足导致营养不良,且处于癌症晚期。因此,食管癌患者术前往往已有不同程度的心脏、肺部或肾功能障碍。从这一角度来看,我们必须非常谨慎地照料这类患者,有时要做出降低手术根治性的决定。本部分描述了伴有心脏、肺部和肾功能障碍的术前并发症的处理。此类并发症必须在根治性手术前进行治疗,并由心脏病专家、肺科医生和麻醉医生进行评估。