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Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
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Related Experiment Video

Updated: Mar 13, 2026

An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
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Current trends in anesthesia for esophagectomy.

Chris Durkin1, Travis Schisler, Jens Lohser

  • 1Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver General Hospital, Vancouver, British Columbia, V5Z-1M9, Canada.

Current Opinion in Anaesthesiology
|October 21, 2016
PubMed
Summary

Enhanced recovery pathways improve outcomes for esophagectomy patients by optimizing ventilation, fluid therapy, and analgesia. While promising, these enhanced recovery pathways need more robust evidence for widespread adoption in high-risk surgical cases.

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Area of Science:

  • Anesthesiology
  • Thoracic Surgery
  • Critical Care Medicine

Background:

  • Esophagectomy remains a high-risk procedure with significant morbidity and mortality.
  • Recent advancements focus on evidence-based perioperative care and expedited recovery.
  • Anesthetic management plays a crucial role in optimizing patient outcomes.

Purpose of the Study:

  • To review recent literature on anesthetic management for esophagectomy.
  • To summarize current evidence on perioperative optimization strategies.
  • To highlight the role of enhanced recovery pathways in reducing complications.

Main Methods:

  • Review of recent scientific literature on esophagectomy anesthetic management.
  • Analysis of enhanced recovery pathways and their components.
  • Evaluation of minimally invasive surgical approaches.

Main Results:

  • Lung protective ventilation reduces pulmonary complications.
  • Restrictive fluid therapy is safe and may reduce acute kidney injury.
  • Thoracic epidural analgesia improves pain control but requires careful monitoring.
  • Enhanced recovery pathways show promise but lack strong evidence.
  • Minimally invasive esophagectomy offers comparable outcomes to open procedures.

Conclusions:

  • Esophagectomy outcomes have improved, but morbidity and mortality remain significant.
  • Enhanced recovery pathways offer potential for further gains.
  • Further large-scale, prospective evidence is needed to validate enhanced recovery pathways.