Abstract | BACKGROUND AND OBJECTIVES:
Esophageal cancer is a leading cause of cancer death worldwide, and esophageal resection is associated with extremely high perioperative morbidity and mortality. A perioperative clinical pathway for esophagectomy patients in which anesthetic care is both integral and standardized has not been described previously. METHODS: A continuously refined clinical pathway for perioperative care of the esophagectomy patient has been developed at the Virginia Mason Medical Center over the past 22 years. Ongoing data collection records patient demographics, comorbidities, tumor stage, and various outcomes including intensive care unit and hospital length of stay, surgical complications, and morbidity and mortality rates. RESULTS: CONCLUSIONS: We present a detailed anesthetic and surgical perioperative pathway for esophageal resection, along with evidence of improved or stable patient outcomes despite an increase in comorbidity burden and increasingly advanced tumor stage.
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Authors | Grete H Porteous, Joseph M Neal, April Slee, Henner Schmidt, Donald E Low |
Journal | Regional anesthesia and pain medicine
(Reg Anesth Pain Med)
2015 Mar-Apr
Vol. 40
Issue 2
Pg. 139-49
ISSN: 1532-8651 [Electronic] England |
PMID | 25658034
(Publication Type: Journal Article)
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Topics |
- Aged
- Anesthesia
(methods, standards)
- Anesthesia, Epidural
- Comorbidity
- Esophageal Neoplasms
(surgery)
- Esophagectomy
- Esophagus
(surgery)
- Female
- Hospital Mortality
- Humans
- Length of Stay
- Male
- Middle Aged
- Pain Clinics
- Treatment Outcome
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