References

mvjr

Медицинский вестник Юга России

Medical Herald of the South of Russia

2219-80752618-7876

The Rostov State Medical University

10.21886/2219-8075-2014-4-5-11

mvjr-23

Research Article

ОБЗОРЫ

REVIEW

ПЕРИОПЕРАТИВНОЕ ЛЕЧЕНИЕ И ОСЛОЖНЕНИЯ АДЕНОКАРЦИНОМЫ ПИЩЕВОДА И ПИЩЕВОДНО-ЖЕЛУДОЧНОГО ПЕРЕХОДА

PERIOPERATIVE AND COMPLICATION MANAGEMENT FOR ADENOCARCINOMA OF THE ESOPHAGUS AND ESOPHAGOGASTRIC JUNCTION

Tobias

tobis.beckurts@koeln-kh-augustinerinnen.de

Beckurts

Отделение общей, висцеральной и травматической хирургии, Больница Аугустинериннен Нотфалль, Кёльнский университетГерманияDepartment for General, Visceral and Trauma Surgery, Krankenhaus der Augustinerinnen Academic Teaching Hospital, University of CologneGermany

2014

30122014

04511

2014

Tobias K., Beckurts E.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.medicalherald.ru/jour/article/view/23

Эзофагэоэктомия остается сложным и тяжелым оперативным вмешательством как для пациента, так и для хирурга. Необходим тщательный отбор пациентов, которым возможно выполнение данного вмешательства. Использование современных оперативных методов и технологий и, в некоторых случаях, последовательность вмешательств, помогают снизить операционную травму. Региональная анестезия, индивидуализированный подход к периоперационному лечению боли, ранняя экстубация, ограничение жидкости, активизация пациента, физиотерапия значительно улучшают лечение. Быстрое распознание и агрессивное диагностическое обследование осложнений в послеоперационном периоде необходимы для предотвращения неконтролируемого прогрессирования патофизиологических каскадов. Кооперация между хирургом, анестезиологом, эндоскопистом, рентгенологом и другими специалистами необходима для снижения периоперационных осложнений и смертности при таком травматичном оперативном вмешательстве.

Esophagectomy remains a challenging procedure both for the patient and the surgeon. Patient selection and evaluation aims at preventing individuals unfit for surgery or without chance of cure from this operation. The use of modern operative techniques and in some cases sequential strategies help reduce the operative trauma. Regional anesthaesia and an individualized concept of perioperative pain treatment, early extubation, fluid restriction, mobilisation and physiotherapeutic assistance aims at the prevention of pulmonary complications, one of the dominant threats to this patient population. Rapid recognition and aggressive diagnostic work-up of any complication, especially anastomotic leaks, in the post-operative period is essential to prevent an uncontrolled progression of pathophysiologic cascades. A close multidisciplinary cooperation of surgeons, anaesthetists, endoscopists, radiologists and other associated disciplines is essential to further reduce the perioperative morbidity and mortality in this demanding surgical procedure.

пищеводаденокарциномахирургияосложнениялегкие

esophagusadenocarcinomasurgerycomplicationlungs

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The authors declare that there are no conflicts of interest present.