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Shestakov A.L.

Petrovsky Russian Research Center of Surgery

Tarasova I.A.

Petrovsky Russian Scientific Center of Surgery

Tskhovrebov A.T.

Petrovsky Russian Research Centre of Surgery

Boeva I.A.

Petrovsky Russian Scientific Center of Surgery

Bitarov T.T.

Petrovsky Russian Research Centre of Surgery

Bezaltynnykh A.A.

Petrovsky Russian Scientific Center of Surgery

Shakhbanov M.E.

Petrovsky Russian Research Centre of Surgery

Dergunova A.P.

Petrovsky National Research Center of Surgery

Vasileva E.S.

The first medical and pedagogical center «Lingua Bona»

Reconstructive esophageal surgery in fast track epoch

Authors:

Shestakov A.L., Tarasova I.A., Tskhovrebov A.T., Boeva I.A., Bitarov T.T., Bezaltynnykh A.A., Shakhbanov M.E., Dergunova A.P., Vasileva E.S.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2021;(6‑2): 73‑83

DOI: 10.17116/hirurgia202106273

Views: 1689

Downloaded: 42

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Table of contents

RECONSTRUCTIVE ESOPHAGEAL SURGERY IN FAST TRACK EPOCH
RECONSTRUCTIVE ESOPHAGEAL SURGERY IN FAST TRACK EPOCH

To cite this article:

Shestakov AL, Tarasova IA, Tskhovrebov AT, et al. . Reconstructive esophageal surgery in fast track epoch. Pirogov Russian Journal of Surgery. 2021;(6‑2):73‑83. (In Russ.)
https://doi.org/10.17116/hirurgia202106273

Подписка 2025-2 (Pirogov Russian Journal of Surgery)
МСФ на ЯМ
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OBJECTIVE

To evaluate an efficiency and safety of perioperative fast track management in reconstructive esophageal surgery.

MATERIAL AND METHODS

Perioperative fast track management protocol in reconstructive esophageal surgery has been applied since 2014 at the Department of Thoracoabdominal Surgery and Oncology of the Petrovsky Russian Scientific Center of Surgery. These patients (2017-2020) were included in the main group (n=75). Patients who underwent traditional perioperative care (2010-2013) were enrolled in the control group (n=63). The primary outcome was postoperative hospital-stay. We also evaluated ICU stay, incidence of complications according to Clavien-Dindo grading system with particular registration of respiratory complications, mortality, enteral and oral feeding onset.

RESULTS

There were no significant between-group differences in sex, age, ASA grade, body mass index. Fast track management reduced hospital-stay from 14 (12; 17) days in the control group to 11 (8; 22) days in the main group (p=0.008). Mean ICU-stay decreased up to 1 (0.8; 2) day in the main group compared to the control group (4.1 (3.5; 5.6) days, p<0.0001). Pneumonia was noted in 5 patients after fast track recovery and 15 patients in the control group (p=0.004). No patients died in the main group, 3 (4.8%) patients — in the control group (p=1).

CONCLUSION

Modern perioperative fast track management protocol is safe and effective for extensive reconstructive esophageal interventions. This approach reduces hospital-stay and ICU stay, as well as the incidence of respiratory complications.

Keywords:

esophageal resection
esophagoplasty
enhanced recovery after surgery
fast track
postoperative rehabilitation

Authors:

Shestakov A.L.

Petrovsky Russian Research Center of Surgery

Tarasova I.A.

Petrovsky Russian Scientific Center of Surgery

Tskhovrebov A.T.

Petrovsky Russian Research Centre of Surgery

Boeva I.A.

Petrovsky Russian Scientific Center of Surgery

Bitarov T.T.

Petrovsky Russian Research Centre of Surgery

Bezaltynnykh A.A.

Petrovsky Russian Scientific Center of Surgery

Shakhbanov M.E.

Petrovsky Russian Research Centre of Surgery

Dergunova A.P.

Petrovsky National Research Center of Surgery

Vasileva E.S.

The first medical and pedagogical center «Lingua Bona»

Received:

13.04.2021

Accepted:

29.04.2021

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