Kyobu geka. The Japanese journal of thoracic surgery · 2012
[Important factors surrounding chest surgery for the patients complicated with digestive disease].
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Tagawa T, Machino R, Doi R, Toyama K
Аннотация
OBJECTIVE: Important factors surrounding chest surgery for the patients complicated with digestive disease were discussed according to the experiences of clinical settings.
METHODS: Check points regarding each context, preoperative, perioperative, postoperative, and outpatient care were considered independently.
RESULTS: If digestive diseases are uncontrolled, the operation should be postponed until they are appropriately cared. Dental problems such as teeth caries or denture insufficiency should be cleared preoperatively. Dysphagia after the head and neck surgery must be evaluated and alternative feeding methods should be established. The patients with digestive tract disorder have malabsorption and are prone to malnutrition. According to the appropriate assessments of digestion and absorption, an enteral nutrition or a total parenteral nutrition should be considered before and after operation, to improve nutrition status. Immunonutrition is particularly beneficial to reduce the postoperative infection or various stresses of invasive operations in the chest surgery. Chronic pancreatitis is characterized by absorption impairment and pancreatic diabetes. They should also be controlled before the operation using digestive enzymes and an exogenous insulin.
CONCLUSION: Teeth problems, dysphagia, malabsorption, malnutrition and pancreatic diabetes should be assessed and cared appropriately before and after the chest surgery using compensative therapy.
METHODS: Check points regarding each context, preoperative, perioperative, postoperative, and outpatient care were considered independently.
RESULTS: If digestive diseases are uncontrolled, the operation should be postponed until they are appropriately cared. Dental problems such as teeth caries or denture insufficiency should be cleared preoperatively. Dysphagia after the head and neck surgery must be evaluated and alternative feeding methods should be established. The patients with digestive tract disorder have malabsorption and are prone to malnutrition. According to the appropriate assessments of digestion and absorption, an enteral nutrition or a total parenteral nutrition should be considered before and after operation, to improve nutrition status. Immunonutrition is particularly beneficial to reduce the postoperative infection or various stresses of invasive operations in the chest surgery. Chronic pancreatitis is characterized by absorption impairment and pancreatic diabetes. They should also be controlled before the operation using digestive enzymes and an exogenous insulin.
CONCLUSION: Teeth problems, dysphagia, malabsorption, malnutrition and pancreatic diabetes should be assessed and cared appropriately before and after the chest surgery using compensative therapy.