4 . 2023

Esophagectomy with immediate reconstruction under fast track program

Abstract

Esophagectomy (EE) with immediate reconstruction is an operation with a high risk of complications (up to 74%). Postoperative mortality in high-flow centers is 4.5%, and in small volume hospitals – 17.4%. Early rehabilitation improves the results of surgical treatment. The article presents a single-center experience of clinical application of the program of rational accelerated perioperative rehabilitation of patients after EE. Under this program 400 primary operations for benign and malignant diseases of the esophagus were perfomed from 2012 to 2021. The median postoperative duration of stay was 9 days. Postoperative complications occurred in 33% patients. The most common complication was postoperative pneumonia (9.25%). Manual esophageal anastomotic leakage was diagnosed in 5% of patients, and conduit necrosis – in 2.25%. Only 39 (9.75%) patients had complications more severe than grade IIIa according to Clavien–Dindo. Hospital mortality was 1.75%. The program of rational accelerated rehabilitation of patients improved the results of EE with mmediate reconstruction of the esophagus.

Keywords:esophagectomy; esophagoplasty; fast track

Funding. The study had no sponsor support.

Conflict of interest. The authors declare no conflict of interest.

For citation: Ruchkin D.V., Kovalerova N.B., Okonskaya D.E., Hamidov M.M. Esophagectomy with immediate reconstruction under fast track program. Clinical and Experimental Surgery. Petrovsky Journal. 2023; 11 (4): 7–16. DOI: https://doi.org/10.33029/2308-1198-2023-11-4-7-16 (in Russian)

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