Factors resulting in postoperative dysphagia following esophagectomy: a narrative review

Abstract

Esophagectomy is a technically involved surgery and can have significant postoperative morbidity. Although the mortality rate following esophagectomy has decreased in recent years, this surgical procedure has a relatively high complication rate compared to other surgeries to resect cancer. One of the most common complaints after esophagectomy is dysphagia. Dysphagia after esophagectomy can significantly affect quality of life. Dysphagia is a complication following esophagectomy that can lead to respiratory deterioration and death. The most common sites of postoperative dysphagia are the gastroesophageal anastomosis, gastric conduit, pylorus and the hiatus. Without appropriate treatment of dysphagia, malnutrition and dehydration can develop. These factors can lead to significant impacts to the overall health of a patient and increase mortality. A detailed literature review provided data to support diagnostic modalities and management strategies to treat postoperative dysphagia at these common areas. A systematic, evidencebased approach to diagnosis and treatment of postoperative dysphagia allows for prompt intervention and a decrease in morbidity and mortality. Treatment options for dysphagia vary, depending on the etiology. Based on the location and mechanism of dysphagia, options include stenting, dilation and surgical revision. Early treatment of dysphagia after esophagectomy can lessen the morbidity from this complication and improve quality of life.

A nyelőcsőpótlás szövődményei

“…Saját tapasztalatunk az, hogy az epés reflux okozta anastomosisszűkületek tágító kezelése nehezebb, mint az egyéb okú szűkületeké, mert a tágítások közötti intervallum nem növelhető. Míg a reflux nélküli szűkületek általában két tágításra meggyógyulnak, addig az epés reflux miatt kialakultakat akár évekig kell tágítani [33]. A savas és a kevert reflux hatására az oesophagogastricus anastomosis felett columnaris metaplasia alakulhat ki, egyes szerzők szerint akár az esetek 50%-ában [34], és kb.…”

Nutrition Monitoring in Post-Surgery Patient with Type 2 Diabetes Mellitus

“…Kurang lebih 10% dari 23 pasien yang menjalani esofagektomi mengalami penurunan berat badan pada 6 bulan pertama [44]. Selain itu, kondisi disfagia juga dapat diakibatkan karena pembedahan ini sebagai salah satu komplikasi jangka panjang [45]. Adanya disfagia ini dapat berujung pada kondisi defisit nutrisi [46].…”

Association of Conduit Dimensions with Perioperative Outcomes and Long-Term Quality of Life after Esophagectomy for Malignancy

“…The gastric conduit is the preferred replacement for the esophagus, and several reconstruction techniques have been devised to optimize its functional effectiveness and improve the quality of life. 3 , 4 , 5 To date, there are no quantitative data correlating conduit dimensions and long-term quality of life. Our study examined whether dimensional parameters from the initial postoperative computed tomography (CT) scan relate to perioperative outcomes and the patient's quality of life at least 18 months after esophagectomy.…”