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Surgery Today
Published in: Surgery Today 3/2014

01-03-2014 | Original Article

Risk factors for pulmonary complications after esophagectomy for esophageal cancer

Authors: Naoya Yoshida, Masayuki Watanabe, Yoshifumi Baba, Shiro Iwagami, Takatsugu Ishimoto, Masaaki Iwatsuki, Yasuo Sakamoto, Yuji Miyamoto, Nobuyuki Ozaki, Hideo Baba

Published in: Surgery Today | Issue 3/2014

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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.
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Metadata
Title
Risk factors for pulmonary complications after esophagectomy for esophageal cancer
Authors
Naoya Yoshida
Masayuki Watanabe
Yoshifumi Baba
Shiro Iwagami
Takatsugu Ishimoto
Masaaki Iwatsuki
Yasuo Sakamoto
Yuji Miyamoto
Nobuyuki Ozaki
Hideo Baba
Publication date
01-03-2014
Publisher
Springer Japan
Published in
Surgery Today / Issue 3/2014
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-013-0577-6

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