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Management of Postoperative Complications in Esophagogastric Surgery

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Acute Care Surgery Handbook

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Abstract

Recent advancements in minimally invasive surgery have changed the scenario of the management of cancer of the esophagus and stomach compared to the past century. The evolution of surgical technique has been paralleled by an increasing tendency, at least in high-volume centers, to apply “fast-track” protocols according to the enhanced recovery after surgery (ERAS) principles in patients undergoing esophagogastrectomy for cancer [1, 2]. Nonetheless, these methodological changes have not yet definitely impacted on postoperative morbidity. Complications continue to occur despite a steady decline of operative mortality [3]. Postoperative morbidity and mortality after upper gastrointestinal surgery still depend on the preoperative physiological patient status, comorbidity, use of neoadjuvant therapy, and also on the anesthetic and intensive care approach. Therefore, good case selection, appropriate choice of the operative strategy, and careful postoperative monitoring continue to play a critical role in preventing the potential catastrophic consequences of surgical complications [4]. Finally, it has been shown that technical complications of esophagogastric surgery also have a profound negative impact on patient survival, and, as a consequence, strategies to optimize surgical techniques and minimize complications have the potential to improve long-term outcomes [5].

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Authors and Affiliations

  1. Department of Surgery, IRCCS Policlinico San Donato, University of Milan Medical School, Milano, Italy

    Emanuele Asti & Luigi Bonavina

Authors
  1. Emanuele Asti
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  2. Luigi Bonavina
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Corresponding author

Correspondence to Luigi Bonavina .

Editor information

Editors and Affiliations

  1. Emergency and Trauma Surgery Service, C.A. Pizzardi Maggiore Hospital AUSL Bologna, Bologna, Italy

    Salomone Di Saverio

  2. Surgery and Emergency, Maggiore Hospital of Parma, Parma, Italy

    Fausto Catena

  3. General, Emergency and Trauma Surgery, Papa Giovanni XXIII Hospital, Bergamo, Italy

    Luca Ansaloni

  4. General, Emergency and Trauma Surgery, Papa Giovanni XXIII Hospital, Bergamo, Italy

    Federico Coccolini

  5. Trauma, Emergency Medicine, Harvard Medical School Massachusetts General Hospital, Boston, Massachusetts, USA

    George Velmahos

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Asti, E., Bonavina, L. (2016). Management of Postoperative Complications in Esophagogastric Surgery. In: Di Saverio, S., Catena, F., Ansaloni, L., Coccolini, F., Velmahos, G. (eds) Acute Care Surgery Handbook. Springer, Cham. https://doi.org/10.1007/978-3-319-15362-9_5

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  • DOI: https://doi.org/10.1007/978-3-319-15362-9_5

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-15361-2

  • Online ISBN: 978-3-319-15362-9

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