[Surgery and Perioperative Management of Esophageal Cancer Patients with Malnutrition].

The incidence of postoperative morbidity and mortality are higher in patients with preoperative malnutrition in esophageal cancer patients. Oral intake tends to decrease during preoperative chemotherapy, and nutritional status is likely to worsen. When nutrition intake decreases, catabolism increases and muscle mass can decrease. It has been reported that related to preoperative sarcopenia and the onset and prognosis of postoperative complications. It has been reported to be associated with preoperative sarcopenia and the incident of postoperative complications and prognosis. Early nutritional assessment and interventions should improve nutritional status before surgery. Amino acid intake and exercise therapy improve exercise capacity such as walking. It is expected that a synergistic effect on the improvement of long-term prognosis by nutrition therapy and exercise therapy. Our hospital has introduced a enhanced preoperative nutrition rehabilitation program for undernourished patients. Immuno-nutrition therapy, exercise therapy, and postexercise branched-chain amino acid preparations are administered. During surgery for such malnourished patient, it is necessary to minimize the surgical invasion and to avoid complications. It is important to have continuous nutritional evaluation, intervention and rehabilitation by various occupations from the initial diagnosis to the perioperative period as well as during outpatient follow-up after discharge.