Perioperative infection control in patients undergoing esophagectomy for cancer

• Published in: Journal of Japan Society for Surgical Infection Vol. 20; no. 2; pp. 92 - 100
• Main Authors: Nabeya, Yoshihiro, Kuwayama, Naoki, Shuto, Kiyohiko, Kano, Masayuki, Suito, Hiroshi
• Format: Journal Article
• Language: Japanese
• Published: Japan Society for Surgical Infection 15.09.2023; 一般社団法人 日本外科感染症学会
• Subjects: remote infection (RI); surgical site infection (SSI); 手術部位感染surgical site infection（SSI）; 術後感染性合併症; 遠隔部位感染remote infection（RI）; 食道切除再建術
• ISSN: 1349-5755; 2434-0103
• DOI: 10.24679/gekakansen.20.2_92

In esophagectomy followed by reconstruction for cancer（esophageal cancer surgery）, postoperative infectious complication（PIC）is a poor prognosticator for long-term as well as short-term outcome. In recent years, thoracoscopic/robot-assisted minimally invasive esophagectomy（MIE）has become widespread, and helped reduce surgical site infection（SSI）not associated with anastomotic failure（AF）and pneumonia as remote infection. However, the incidence of organ/space SSI due to AF is still high, and countermeasures are essential for improving the prognosis.Until now, in addition to treatment-related factors such as surgery, patient factors such as advanced age, malnutrition, and comorbidities have been identified as risk factors for developing PIC, but there is little evidence of countermeasures due to differences in treatment methods among facilities. In the MIE era, in addition to safe surgery with few AFs, infection control with team medical care, including individualized perioperative management according to risk, early diagnosis and appropriate treatment of complications, and appropriate use of antibiotics, is required. In the future, the spread of preventive medicine and social nutrition to minimize the risk factors for PIC in patients diagnosed with esophageal cancer will also become one of the infection control measures in a broad sense.