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Langenbeck's Archives of Surgery

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01-01-2015 | Original Article

Short- and long term effects of epidural analgesia on morbidity and mortality of esophageal cancer surgery

Authors: Sebastian Heinrich, Katrin Janitz, Susanne Merkel, Peter Klein, Joachim Schmidt

Published in: Langenbeck's Archives of Surgery | Issue 1/2015

Abstract

Purpose

Perioperative regional anesthesia with consecutive reduction of intra- and postoperative systemic opioid requirements in order to improve oncological result after cancer surgery has only been addressed by a few reports. This hypothesis has never been proved in esophageal cancer with a long-term follow-up of more than 5 years. Therefore, we addressed the impact on short- and long-term outcomes of epidural analgesia for esophagus cancer surgery.

Methods

All available records from patients who underwent esophageal cancer surgery from 1995 to 2005 were retrospectively analyzed. Short- and long-term outcome variables including opioid requirements, duration of ICU-stay, survival, and cancer recurrence were compared between patients with and patients without epidural analgesia for abdomino-right-thoracic esophagectomy.

Results

Overall, the analysis included 153 patients, 118 received epidural analgesia; in 35 patients, epidural analgesia was avoided. We found significantly increased postoperative median opioid consumption (10-day intravenous morphine equivalent 187 versus 104 mg) and duration of ICU hospitalization (10.1 vs. 5.9 days, p < 0.05) in the non-epidural group compared with the epidural group. However, there were no significant differences in cancer recurrence (23 % non-epidural group, 27 % epidural group), 1-year mortality (14 vs. 11 %), or 5-year survival (29 vs. 28 %) between the two patient groups.

Conclusions

The results of our study underline the well-known clinical benefits of epidural analgesia for esophagus surgery. However, we found no evidence that the further oncological outcome is determined or significantly influenced by the presence or absence of epidural analgesia.

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Title: Short- and long term effects of epidural analgesia on morbidity and mortality of esophageal cancer surgery
Authors: Sebastian Heinrich
Katrin Janitz
Susanne Merkel
Peter Klein
Joachim Schmidt
Publication date: 01-01-2015
Publisher: Springer Berlin Heidelberg
Published in: Langenbeck's Archives of Surgery / Issue 1/2015
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-014-1248-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Short- and long term effects of epidural analgesia on morbidity and mortality of esophageal cancer surgery

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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