Related Experiment Video
Updated: Jun 26, 2026
09:40
An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
Published on: April 17, 2020
Fast track clinical pathway implications in esophagogastrectomy
Ke Jiang1, Lin Cheng, Jian-Jun Wang
1Department of Thoracic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China. kkkj_77@yahoo.com.cn
World Journal of Gastroenterology
|January 20, 2009
Summary
Fast track clinical pathways are feasible for esophageal tumor resections, reducing hospital stays to a median of 7 days. Patients without preoperative conditions, especially those under 65, benefit most from this approach.
Area of Science:
- Oncology
- Surgical Gastroenterology
- Clinical Pathway Research
Background:
- Esophageal carcinoma necessitates complex surgical interventions.
- Optimizing patient recovery and reducing hospital stay are critical goals in surgical oncology.
Purpose of the Study:
- To evaluate the feasibility and outcomes of implementing a fast track clinical pathway for patients undergoing esophagogastrectomy for esophageal tumors.
Main Methods:
- A retrospective study of 114 patients with esophageal carcinoma undergoing esophagogastrectomy.
- Implementation of a fast track protocol including controlled analgesia, fluid management, early ambulation, and enteral nutrition.
Main Results:
- 26 patients (23%) were eligible for the fast track pathway, with younger patients (<65 years) showing better tolerance.
- No significant differences in tolerance were observed based on gender, tumor differentiation, stage, or pathological type.
- Median hospital stay was reduced to 7 days, with a 2.6% postoperative mortality rate.
Conclusions:
- Fast track clinical pathways are generally well-tolerated by patients with esophageal carcinoma.
- Patients without preoperative comorbidities, particularly those under 65, achieve the best outcomes with this pathway.
- The fast track approach significantly reduces median hospital length of stay for esophageal cancer surgery.
Related Concept Videos
01:21Barrett Esophagus-II: Clinical Manifestations and Management
Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure entails...
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure entails...
01:26Esophageal Strictures-II: Clinical Features and Management
Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
01:29Endoscopic Procedures I: Esophagogastroduodenoscopy
An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
During an EGD, the endoscope can be used to:
During an EGD, the endoscope can be used to:
01:28Esophageal Varices-II: Clinical Features and Management
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...
01:28Esophageal Perforation-II: Clinical Manifestations and Management
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
01:29Gastroesophageal Reflux Disease II: Clinical Features and Management
Gastroesophageal reflux disease, or GERD, is a persistent medical condition that affects many individuals worldwide. Its clinical manifestations can vary greatly, making diagnosis and management challenging for healthcare professionals. The following is a comprehensive overview of the clinical manifestations, assessment, and management strategies for GERD.
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...