Risk Factors for Pulmonary Complications After Esophagectomy for Esophageal Cancer

Overview

Journal Surg Today

Specialty General Surgery

Date 2013 Apr 16

PMID 23584275

Citations 53

Authors

Naoya Yoshida

Masayuki Watanabe

Yoshifumi Baba

Shiro Iwagami

Takatsugu Ishimoto

Masaaki Iwatsuki

Yasuo Sakamoto

Yuji Miyamoto

Nobuyuki Ozaki

Hideo Baba

Affiliations

Soon will be listed here.

Abstract

Purpose: Pulmonary complications after esophagectomy are still common and are a major cause of mortality. The aim of this study was to clarify the risk factors for the occurrence of pulmonary complications after esophagectomy.

Methods: The clinical courses of 299 patients who underwent elective subtotal esophagectomy with lymph node dissection for esophageal cancer were retrospectively analyzed. Group I included patients who had pulmonary complications (n = 53), and group II included patients who did not (n = 246). The clinicopathological factors, surgical procedures and surgical results were compared between the groups.

Results: The frequency of any pulmonary complication was 17.7 %. Pneumonia (n = 26; 8.7 %) and respiratory failure that needed initial ventilatory support for 48 h or reintubation (n = 16; 5.4 %) were the major morbidities. The results of the logistic regression analysis suggested that smoking with a Brinkman index ≥800, salvage esophagectomy after definitive chemoradiotherapy and the amount of blood loss/body weight were independent factors associated with the occurrence of pulmonary complications.

Conclusion: Pulmonary complications after esophagectomy remain common despite advances in perioperative management. Cases with a history of heavy smoking, preoperative definitive chemoradiotherapy, and high blood loss during surgery require more careful postoperative pulmonary care.

Citing Articles

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Huo Z, Chong F, Luo S, Tong N, Lu Z, Zhang M Support Care Cancer. 2024; 33(1):31.

PMID: 39680175 DOI: 10.1007/s00520-024-09060-7.

Enhancing Preoperative Outcome Prediction: A Comparative Retrospective Case-Control Study on Machine Learning versus the International Esodata Study Group Risk Model for Predicting 90-Day Mortality in Oncologic Esophagectomy.

Winter A, van de Water R, Pfitzner B, Ibach M, Riepe C, Ahlborn R Cancers (Basel). 2024; 16(17).

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Preventing Pneumonia in High-risk Patients After Esophageal Cancer Surgery: Mini-tracheostomy and Tazobactam/Piperacillin.

Nishiyama M, Takeda S, Watanabe Y, Iida M, Yamamoto T, Nakashima C In Vivo. 2024; 38(4):1790-1798.

PMID: 38936906 PMC: 11215583. DOI: 10.21873/invivo.13630.

Smoking status predicts anastomotic leak after esophagectomy: a systematic review & meta-analysis.

Bedard A, Valji R, Jogiat U, Verhoeff K, Turner S, Karmali S Surg Endosc. 2024; 38(8):4152-4159.

PMID: 38902404 DOI: 10.1007/s00464-024-10988-4.

Perioperative Risk Factors for Postoperative Pulmonary Complications After Minimally Invasive Esophagectomy.

Li X, Yu L, Fu M, Yang J, Tan H Int J Gen Med. 2024; 17:567-577.

PMID: 38374814 PMC: 10876009. DOI: 10.2147/IJGM.S449530.

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