Anaesthesia for oesophagectomy.
OBJECTIVE
To review the current anaesthetic management of patients undergoing transthoracic oesophagectomy.


RESULTS
Oesophageal adenocarcinoma is increasing rapidly in the West. The perioperative mortality for oesophagectomy remains high. A relationship has been established between volume and outcome for oesophageal surgery. There is little evidence from randomized clinical studies to guide the management of patients undergoing oesophagectomy. The profile of patients presenting for oesophagectomy is changing. There is emerging evidence that anaesthetic management influences outcome. At present there are no clear advantages for minimal access surgery.


CONCLUSIONS
Although nonsurgical treatments are being developed, at present surgery remains the mainstay of potentially curative treatment. Accurate risk stratification would greatly facilitate the assessment of strategies to reduce operative mortality. Anaesthetic research has the potential to further improve the safety of patients undergoing oesophageal surgery.
Pennefather
Stephen H
SH
The Cardiothoracic Centre, Liverpool, UK. stephen.pennefather@ctc.nhs.uk
D000758:Anesthesia; D017024:Chemotherapy, Adjuvant; D016629:Esophagectomy; D006801:Humans; D019060:Minimally Invasive Surgical Procedures; D018529:Nutritional Support; D010149:Postoperative Pain / Q000188:drug therapy; D018579:Patient Selection; D019990:Perioperative Care