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Review
. 2021 Nov;406(7):2249-2261.
doi: 10.1007/s00423-021-02203-y. Epub 2021 May 25.

Functional syndromes and symptom-orientated aftercare after esophagectomy

Kristjan Ukegjini  1   2 , Diana Vetter  1 , Rebecca Fehr  3 , Valerian Dirr  1 , Christoph Gubler  4 , Christian A Gutschow  5
Affiliations
Review

Functional syndromes and symptom-orientated aftercare after esophagectomy

Kristjan Ukegjini et al. Langenbecks Arch Surg. 2021 Nov.

Abstract

Background: Surgery is the cornerstone of esophageal cancer treatment but remains burdened with significant postoperative changes of gastrointestinal function and quality of life.

Purpose: The aim of this narrative review is to assess and summarize the current knowledge on postoperative functional syndromes and quality of life after esophagectomy for cancer, and to provide orientation for the reader in the challenging field of functional aftercare.

Conclusions: Post-esophagectomy syndromes include various conditions such as dysphagia, reflux, delayed gastric emptying, dumping syndrome, weight loss, and chronic diarrhea. Clinical pictures and individual expressions are highly variable and may be extremely distressing for those affected. Therefore, in addition to a mostly well-coordinated oncological follow-up, we strongly emphasize the need for regular monitoring of physical well-being and gastrointestinal function. The prerequisite for an effective functional aftercare covering the whole spectrum of postoperative syndromes is a comprehensive knowledge of the pathophysiological background. As functional conditions often require a complex diagnostic workup and long-term therapy, close interdisciplinary cooperation with radiologists, gastroenterologists, oncologists, and specialized nutritional counseling is imperative for successful management.

Keywords: Delayed gastric emptying; Dumping syndrome; Dysphagia; Esophagectomy; Functional aftercare; Functional syndromes; Quality of life.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Anastomotic stricture after esophagectomy with gastric conduit reconstruction and intrathoracic anastomosis. a) Impacted food bolus b) Anastomotic stricture
Fig. 2
Fig. 2
Plain chest X-ray showing a dilated gastric conduit with air-fluid level in a patient with DGE after esophagectomy and gastric conduit reconstruction
Fig. 3
Fig. 3
Endoscopic aspect of food residua in the gastric conduit in a patient with DGE
Fig. 4
Fig. 4
Fluoroscopy-guided endoscopic dilation of pyloric spasm causing DGE. The black arrow marks the pyloric region. a Before dilation, b balloon dilation, c endoscopic aspect after dilation
Fig. 5
Fig. 5
Diagnostic and therapeutic algorithm for functional syndromes after esophagectomy
See this image and copyright information in PMC

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