Sammanfattning
Introduction: On a nationwide basis, esophageal resection has been followed by an average postoperative stay of 19 days and an in-hospital mortality rate of 11%. We studied a multimodal rehabilitation regimen comprising epidural analgesia, early mobilisation and early oral nutrition to assess the outcome of esophageal resection. Materials and methods: We followed 29 consecutive patients who underwent esophageal resection in the period 1 September 2002-30 April 2003 and who had a planned postoperative stay of seven days. Anaesthesia, the surgical technique and nursing care were standardised. Postoperative follow-up was arranged for days 10, 20 and 30. Results: The median total hospital stay for discharged patients was eight days (range 6-53 days). Two patients died. One patient was readmitted for one day within 30 days. In 12 patients no complications occurred and the median stay was six days (range 6-14 days), whereas nine patients had mild cardiopulmonary complications and stayed for a median of eight days (range 7-16 days). One patient died of myocardial infarction four days after surgery. In seven patients surgical complications occurred; one patient, who suffered from necrosis of the interponated stomach, died 21 days after surgery. Discussion: The study provides evidence in support of the possibility of implementation of an accelerated regimen for patients undergoing esophageal resection, resulting in a shorter hospital stay and a lower morbidity rate.