Complications and Management of Complications After Resection and Reconstruction of the Esophagus

A curative therapy of advanced esophagus carcinoma is primarily made possible by radical esophagectomy with lymphadenectomy. Impressive advances in the surgical techniques of esophageal surgery through minimally invasive and robotic oesophagectomy have been made in the last two decades. The perioperative management with prehabilitation, PDK application, early mobilization and early food intake also contributed significantly to a reduction in complications. However, esophageal surgery is fraught with complications. Anastomotic leakage is the most common technical-surgical complication. The rate is approximately 10 - 16%, independent of the technique and procedure. In addition to an experienced, subtle, atraumatic and rapid surgical technique, early detection (clinical, endoscopic, radiological) and adequate, interdisciplinary management of perioperative complications in resecting esophageal surgery are the key to increasing the safety of these complex interventions. The treatment of the complications includes conservative, interventional and surgical measures. In the last few decades, there has been a radical change from once exclusively surgical revisions with a high degree of invasiveness and a poor outcome to today's mostly conservative-interventional management with little patient burden and - in centers with the appropriate expertise - good results.

Automated summary

Radical esophagectomy with lymphadenectomy is the primary treatment for advanced esophagus carcinoma. Advances in surgical techniques, such as minimally invasive and robotic oesophagectomy, have improved the outcomes in the last two decades. Perioperative management, including prehabilitation, PDK application, early mobilization, and early food intake, also contribute to reducing complications. Early detection and interdisciplinary management are key to increasing the safety of esophageal surgery.