ACCELERATED HOSPITAL REHABILITATION OF PATIENTS AFTER EXTENDED-COMBINED SURGERIES FOR CANCER OF THORACIC ESOPHAGUS AND CARDIA

Abstract

The efficacy of the protocol of preoperative preparation and accelerated rehabilitation of patients in surgical treatment of thoracic esophageal cancer was aevaluated. The protocol was based on the analysis of short-term results of surgical treatment of 190 patients with esophageal cancer. The algorithm devised at the Moscow Research Institute of Oncology was applied to 30 patients with cancer of the esophagus and cardia. Postoperative complications occurred in 12 (40 %) patients of the study group including surgical complications in 4 patients (chylothorax – 2, failure of the esophageal-intestinal anastomosis – 1, small bowel obstruction – 1). Nonsurgical complications in the absence of surgical ones were noted in 7 patients (pneumonia – 6, heart rhythm disturbances – 1). No lethal outcomes were registered. Patients in the control retrospective group (n=50) underwent surgeries in the same extent after the standard preoperative preparation. Postoperative complications in the control group occurred in 28 (48 %) cases, 4 (8 %) patients died. The median postoperative hospital stay was 11 days (range: 10–29 days) in the study group and 18 days in the control group. Accordingly, the above protocol of preoperative examination and preparation of patients allows the frequency of  postoperative complications and lethality to be significantly decreased, thus reducing the hospital stay.