食管癌术后肺部并发症的预测与对策

Prediction and prevention of postoperative pulmonary complications after esophageal cancer surgery

食管切除术是治疗食管癌的基石,作为食管切除术后最常见的并发症,肺部并发症被认为是预测患者预后最重要的因素,预防肺部并发症的发生在食管癌术后有着重要意义。术后肺部并发症一直是食管切除术的研究热点,近期国内专家共识的发表规范了术后肺炎的诊疗措施,但关于肺炎的定义目前仍未得到统一,同时外科新技术的普及仍面临挑战。本文通过检索PubMed、Wiley、Sciencedirect、知网和万方数据库,回顾以往食管切除术后肺部并发症的相关研究报道、综述和指南,进行归纳和总结,从术前状态、手术因素和术后管理3方面阐述食管切除术后肺部并发症的影响因素,并基于此提出一些相应的策略。

Esophagectomy is the cornerstone of the treatment of esophageal cancer.As the most common complication after esophagectomy,pulmonary complications are considered to be the most important prognostic factor.Prevention of pulmonary complications is of great significance after esophageal cancer surgery.Postoperative pulmonary complications have always been a hot research topic in esophagectomy.Recently,the publication of consensus among domestic experts has standardized the diagnosis and treatment measures of postoperative pneumonia in esophageal cancer patients.However,the definition of pneumonia has not been unified,and the popularization of new surgical techniques is still facing challenges.By searching PubMed,Wiley,Sciencedirect,CNKI and Wanfang database,the related research reports,reviews and guidelines on pulmonary complications after esophagectomy were reviewed and summarized.In this paper,the influencing factors of postoperative pulmonary complications after esophagectomy were discussed from three aspects:preoperative state,surgical factors and postoperative management,based on which some corresponding strategies were proposed.