Functional syndromes and symptom-orientated aftercare after esophagectomy.

Kristjan Ukegjini, Diana Vetter, Rebecca Fehr, Valerian Dirr, Christoph Gubler, Christian A Gutschow

Journal: Langenbeck's archives of surgery 2021;406(7):2249-2261

PMID: 34036407

Abstract

BACKGROUND

Surgery is the cornerstone of esophageal cancer treatment but remains burdened with significant postoperative changes of gastrointestinal function and quality of life.

PURPOSE

The aim of this narrative review is to assess and summarize the current knowledge on postoperative functional syndromes and quality of life after esophagectomy for cancer, and to provide orientation for the reader in the challenging field of functional aftercare.

CONCLUSIONS

Post-esophagectomy syndromes include various conditions such as dysphagia, reflux, delayed gastric emptying, dumping syndrome, weight loss, and chronic diarrhea. Clinical pictures and individual expressions are highly variable and may be extremely distressing for those affected. Therefore, in addition to a mostly well-coordinated oncological follow-up, we strongly emphasize the need for regular monitoring of physical well-being and gastrointestinal function. The prerequisite for an effective functional aftercare covering the whole spectrum of postoperative syndromes is a comprehensive knowledge of the pathophysiological background. As functional conditions often require a complex diagnostic workup and long-term therapy, close interdisciplinary cooperation with radiologists, gastroenterologists, oncologists, and specialized nutritional counseling is imperative for successful management.

© 2021. The Author(s).

Address: Department of Visceral and Transplant Surgery, University Hospital Zurich, Zurich, Switzerland.; Department of General, Visceral, Endocrine and Transplant Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland.; Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich, Zurich, Switzerland.; Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland.; Department of Visceral and Transplant Surgery, University Hospital Zurich, Zurich, Switzerland. [email protected].
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