Society for Translational Medicine Expert Consensus on the prevention and treatment of postoperative pulmonary infection in esophageal cancer patients

Yu, Zhentao; Li, Shanqing; Liu, Deruo; Liu, Lunxu; He, Jianxing; Huang, Yunchao; Xu, Shidong; Mao, Weimin; Tan, Qunyou; Chen, Chun; Li, Xiaofei; Zhu, Zhenke; Jiang, Gening; Xu, Lin; Fu, Jianhua; Li, Hui; Wang, Qun; Tan, Lijie; Li, Danqing; Zhou, Qinghua; Fu, Xiangning; Jiang, Zhongmin; Chen, Haiquan; Fang, Wentao; Zhang, Xun; Yin, Li; Tong, Ti; Liu, Yongyu; Zhi, Xiao; Yan, Tao; Zhang, Xingyi; Gong, Lei; Zhang, Hongdian; Downs, John B.; Villamizar, Nestor; Gao, Shugeng

doi:10.21037/jtd.2018.01.34

Cited by 9 publications

(10 citation statements)

References 36 publications

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“…As preoperative malnutrition is associated with an adverse surgical outcome, the integration of early screening for malnutrition and appropriate nutritional support into the overall preoperative management of patients with esophageal cancer is important (4,15,17,36). The risk for late detection of malnutrition exists as patients often do not manifest symptoms early in the disease trajectory.…”

Section: Screening and Assessment Of Malnutritionmentioning

confidence: 99%

“…Alcohol abuse is an independent risk factor for postoperative complications (36,(65)(66)(67), and this appears to show a doseresponse relationship (68). High alcohol consumption (>2 drinks/day, over 28 g ethanol) reduces the immune capacity, cardiac function, increases the endocrine stress response to surgery, reduces blood coagulations and slows down the wound healing process (65,69), all of which are needed for postoperative recovery.…”

Section: Alcohol Interventionmentioning

confidence: 99%

“…Cancer surgery seemed to serve as a kind of refuge and was a useful cue for motivating patients to reconsider the consequences of risky drinking (69,70). Encouraging patients to cease alcohol abuse should be an integral part of preparing for surgery (15,36,69). Alcohol abstinence for at least 4 weeks prior to esophagectomy seems advisable in an enhanced recovery program (15).…”

Section: Alcohol Interventionmentioning

confidence: 99%

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Preoperative nutritional optimization of esophageal cancer patients

Steenhagen¹

2019

J. Thorac. Dis

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Optimization of the nutritional and metabolic state prior to major surgery leads to improved surgical outcomes and is increasingly seen as an important part of oncology disease management. For locally advanced esophageal cancer the treatment is multimodal, including neoadjuvant chemoradiotherapy or perioperative chemotherapy in combination with esophageal resection. Patients undergoing such a multimodal treatment have a higher risk for progressive decline in their nutritional status. Preoperative malnutrition and loss of skeletal muscle mass has been reported to correlate with unfavorable outcomes in patients who undergo esophageal cancer surgery. Decline in nutritional status is most likely caused by insufficient nutritional intake, reduced physical activity, systemic inflammation and the effects of anticancer therapy. To ensure an optimal nutritional status prior to surgery, it is key to assess the nutritional status in all preoperative esophageal cancer patients, preferable early in the treatment trajectory, and to apply nutritional interventions accordingly. Nutritional management of esophageal cancer can be challenging, the optimal nutritional therapy is still under debate, and warrants more nutritional scientific research. In this review, the most recent findings regarding preoperative nutrition associated with outcomes in patients with esophageal cancer will be explored.

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Section: Screening and Assessment Of Malnutritionmentioning

confidence: 99%

Section: Alcohol Interventionmentioning

confidence: 99%

Section: Alcohol Interventionmentioning

confidence: 99%

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Preoperative nutritional optimization of esophageal cancer patients

Steenhagen¹

2019

J. Thorac. Dis

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“…The adverse effects of NAC, such as immune suppression, nausea and vomiting, combined with the clinical symptoms of esophageal tumor itself, will adversely affect the follow-up treatment. It’s very important to integrate the early screening of malnutrition and appropriate nutritional support into the overall preoperative management of esophageal cancer patients [ 13 – 16 ]. According to previous studies, preoperative nutritional support can improve postoperative nutritional status and immune function [ 17 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of immunonutritional supplement after neoadjuvant chemotherapy in patients with esophageal cancer

Luo

Xie

Zhang

et al. 2022

J Cardiothorac Surg

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Background In recent years, preoperative nutrition has received great attention, especially for patients who received surgical reconstruction of the digestive tract such as esophagectomy. Preoperative nutrition therapy was reported to accelerate the patient's postoperative recovery. In addition, immune suppression, nausea, and vomiting may lead to poor immune and nutritional status of patients with esophageal cancer who underwent neoadjuvant chemotherapy (NAC), which is not conducive to surgery. Therefore, preoperative nutritional treatment is necessary for patients with esophageal cancer who underwent NAC. Method Patients with esophageal cancer who received NAC at Nanjing Jinling Hospital from January 2018 to September 2020 were retrospectively identified. Patients were divided into enteral immunonutrition (EIN) group (those who received a conventional diet and immunonutrition supplement, Peptisorb, Nutricia, 500 mL/day * 7 via oral intake), and control group (those who only received a conventional diet were divided into). The primary outcomes were immune and nutritional indicators changes, including immunoglobulin M (IgM), immunoglobulin A (IgA), immunoglobulin G (IgG), and albumin (ALB), which were measured at preoperative day (PRD) 7, PRD-1, postoperative day (POD) 1 and POD-7. The secondary outcomes were postoperative complications, adverse reactions, and length of hospital stay. Results A total of 124 eligible patients were included in the study, with 21 patients in EIN group. After 1:2 matching, significant difference in baseline characteristics between the two groups was not observed (EIN: n = 21, Control group: n = 42). Compared with the control group, the IgA is significantly increased in the EIN group at POD-7 (p = 0.017). However, we observed that the IgM level in the control group was significantly higher than those in the EIN group at POD-7 (p = 0.007). The incidence of pneumonia and total complications in the EIN group were significantly lower than those in control group (p = 0.024, p = 0.028, respectively). There is no significant difference in ALB and adverse reactions between two groups (p = 0.303, p = 0.108, respectively). Conclusion Immunonutritional supplement after NAC is an effective strategy to improve the postoperative immune status of esophageal cancer patients and could reduce the incidence of infectious complication. More well-designed prospective studies are needed to verify and update our finding.

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“…Pain caused by chest wall incision and drainage tube can make patients worry about pain, reduce the depth of breathing, lead to rejection of cough or weak cough, and damage to the ipsilateral pulmonary ventilation function, which prevent effective release and relief of sputum cough. Meanwhile, the application of effective antibiotic therapy is undoubtedly one of the most effective methods to control pulmonary infection [63].…”

Section: Pulmonary Complicationmentioning

confidence: 99%

The treatments and postoperative complications of esophageal cancer: a review

Zhu

et al. 2020

J Cardiothorac Surg

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Esophageal cancer is still one of the most common cancers in the world. We review the appropriate treatments at different stages of esophageal cancer and also analyze the advantages and disadvantages of these treatments. The prognosis and recovery of different treatment regimens are further discussed. In particular, post-operative complications are the major causes of high mortality derived from the esophageal cancer. Therefore, we particularly discuss the main complications resulting in high mortality after surgery of esophageal cancer, and summarize their risk factors and treatment options. Background As the common cancer, the complications of esophageal cancer after surgery have been not obtained systematic treatment strategy, focusing on treatment regimens based on the different stages of esophageal cancers. Methods and overview This paper systematically summarizes the appropriate treatment strategies for different stages of esophageal cancers, and their advantages and disadvantages. We particularly focus on the postoperative survival rate of patients and postoperative complications, and discuss the causes of high mortality risk factors after surgery. The risk factors of death and corresponding treatment methods are further summarized in this study. Conclusion Postoperative complications is the main cause responsible for the hard cure of esophageal cancers. The existing literatures indicate that postoperative anastomotic fistula is one of the most important complications leading to death, while it has not received much attention yet. We suggest that anastomotic fistula should be detected and dealt with early by summarizing these literatures. It is, therefore, necessary to develop a set of methods to predict or check anastomotic fistula in advance.

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Society for Translational Medicine Expert Consensus on the prevention and treatment of postoperative pulmonary infection in esophageal cancer patients

Cited by 9 publications

References 36 publications

Preoperative nutritional optimization of esophageal cancer patients

Preoperative nutritional optimization of esophageal cancer patients

Efficacy of immunonutritional supplement after neoadjuvant chemotherapy in patients with esophageal cancer

The treatments and postoperative complications of esophageal cancer: a review

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