The enhanced recovery after surgery (ERAS) protocol to promote recovery following esophageal cancer resection

被引:129
作者
Ashok, Apurva [1 ]
Niyogi, Devayani [1 ]
Ranganathan, Priya [2 ]
Tandon, Sandeep [3 ]
Bhaskar, Maheema [3 ]
Karimundackal, George [1 ]
Jiwnani, Sabita [1 ]
Shetmahajan, Madhavi [2 ]
Pramesh, C. S. [1 ]
机构
[1] Homi Bhabha Natl Inst, Tata Mem Ctr, Tata Mem Hosp, Dept Surg Oncol,Div Thorac Surg, Mumbai 400012, Maharashtra, India
[2] Homi Bhabha Natl Inst, Tata Mem Ctr, Dept Anesthesiol Crit Care & Pain, Div Thorac Surg, Mumbai, Maharashtra, India
[3] Homi Bhabha Natl Inst, Tata Mem Ctr, Dept Pulm Med, Div Thorac Surg, Mumbai, Maharashtra, India
关键词
Esophageal surgery; Esophagectomy; Enhanced recovery; MINIMALLY INVASIVE ESOPHAGECTOMY; THORACIC EPIDURAL-ANESTHESIA; POSTOPERATIVE COMPLICATIONS; ESOPHAGOGASTRIC JUNCTION; PULMONARY COMPLICATIONS; VENOUS THROMBOEMBOLISM; TRANSHIATAL RESECTION; SMOKING-CESSATION; FLUID MANAGEMENT; TIDAL-VOLUME;
D O I
10.1007/s00595-020-01956-1
中图分类号
R61 [外科手术学];
学科分类号
摘要
Esophageal cancer surgery, comprising esophagectomy with radical lymphadenectomy, is a complex procedure associated with considerable morbidity and mortality. The enhanced recovery after surgery (ERAS) protocol which aims to improve perioperative care, minimize complications, and accelerate recovery is showing promise for achieving better perioperative outcomes. ERAS is a multimodal approach that has been reported to shorten the length of hospital stay, reduce surgical stress response, decrease morbidity, and expedite recovery. While ERAS components straddle preoperative, intraoperative, and postoperative periods, they need to be seen in continuum and not as isolated elements. In this review, we elaborate on the components of an ERAS protocol after esophagectomy including preoperative nutrition, prehabilitation, counselling, smoking and alcohol cessation, cardiopulmonary evaluation, surgical technique, anaesthetic management, intra- and postoperative fluid management and pain relief, mobilization and physiotherapy, enteral and oral feeding, removal of drains, and several other components. We also share our own institutional protocol for ERAS following esophageal resections.
引用
收藏
页码:323 / 334
页数:12
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