Esophagectomy-prevention of complications-tips and tricks for the preoperative, intraoperative and postoperative stage

Updates Surg. 2023 Feb;75(2):343-355. doi: 10.1007/s13304-022-01332-3. Epub 2022 Jul 18.

Abstract

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.

Keywords: Centralisation; Enhanced recovery; Esophagectomy; Indocyanine green.

Publication types

  • Review

MeSH terms

  • Anastomotic Leak / epidemiology
  • Anastomotic Leak / etiology
  • Anastomotic Leak / prevention & control
  • Esophageal Neoplasms* / surgery
  • Esophagectomy* / adverse effects
  • Esophagectomy* / methods
  • Humans
  • Postoperative Complications / epidemiology
  • Quality of Life
  • Retrospective Studies