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Clinical usefulness of sputum culture on the first postoperative day to predict early postoperative pneumonia after esophagectomy for esophageal cancer

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Abstract

Background

Postoperative pneumonia is a serious prognostic problem that can appear after esophagectomy in patients with esophageal cancer. The past reports have considered the usefulness of perioperative culture examinations for predicting postoperative pneumonia; however, the direct relationship between these examinations and postoperative complications remains unclear.

Methods

This study retrospectively analyzed esophageal cancer patients who underwent esophagectomy followed by sputum culture on the first postoperative day. The bacterial species that frequently cause hospital-acquired pneumonia were chosen as the target species in this study. The relationship between culture examination and postoperative pneumonia within one week (7 days) after esophagectomy was investigated.

Results

Sputum cultures on the first postoperative day were investigated in 238 patients who underwent esophagectomy for esophageal cancer. Forty-one patients developed pneumonia within one week after surgery. The target bacterial species were detected in 26 of 238 sputum cultures (10.9%). In the univariate analysis, a Brinkman index, detection of target bacterial species, detection of Gram-positive cocci, and Gram-negative rods were significantly associated with postoperative pneumonia. In the three independent multivariate analyses, the target bacterial species, Gram-positive cocci, and Gram-negative rods (p = 0.001, 0.042, and < 0.001) were individually identified as independent risk factors of postoperative pneumonia in addition to a Brinkman index.

Conclusions

Detection of target bacterial species by sputum culture on the first postoperative day after esophagectomy was an independent risk factor of postoperative pneumonia within 7 days after surgery. Prospective studies for the prevention of early postoperative pneumonia using sputum culture on the first postoperative day can be considered.

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Acknowledgements

The authors thank Kumiko Motooka, a staff member at the Department of Surgery in Keio University School of Medicine, for help in preparation of the manuscript.

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Authors and Affiliations

  1. Department of Surgery, Keio University School of Medicine, 35-banchi, Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Kazuaki Matsui, Hirofumi Kawakubo, Satoru Matsuda, Shuhei Mayanagi, Tomoyuki Irino, Kazumasa Fukuda, Rieko Nakamura, Norihito Wada & Yuko Kitagawa

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  1. Kazuaki Matsui
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  2. Hirofumi Kawakubo
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  3. Satoru Matsuda
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  4. Shuhei Mayanagi
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  5. Tomoyuki Irino
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  6. Kazumasa Fukuda
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  7. Rieko Nakamura
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Corresponding author

Correspondence to Hirofumi Kawakubo.

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Ethical Statement

All procedures were in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1964 and later versions.

Conflict of interest

Yuko Kitagawa reports grants from TAIHO PHARMACEUTICAL CO., LTD., grants from CHUGAI PHARMACEUTICAL CO., LTD., grants from Yakult Honsha Co., Ltd., grants from DAIICHI SANKYO COMPANY, grants from Merck Serono Co., Ltd., grants from AsahiKASEI Co., Ltd., grants from EA Pharma Co., Ltd., grants from Otsuka Pharmaceutical Co., Ltd., grants from Takeda Pharmaceutical Co., Ltd., grants from tsuka Pharmaceutical Factory Inc., grants from SHIONOGI & CO., LTD., grants from KAKEN PHARMACEUTICAL CO., LTD., grants from Kowa Pharmaceutical Co., Ltd., grants from Astellas Pharma Inc., grants from MEDICON INC., DAINIPPON SUMITOMO PHARMA Co., Ltd., grants from Taisho Toyama Pharmaceutical Co., Ltd., grants from Kyouwa Hakkou Kirin Co., Ltd., grants from Pfizer Japan Inc., grants from ONO PHARMACEUTICAL CO., LTD., grants from NIHON PHARMACEUTICAL CO., LTD., grants from Japan Blood Products Organization, grants from Medtronic Japan Co., Ltd., grants from Sanofi K.K., grants from Eisai Co., Ltd., grants from TSUMURA & CO., grants from KCI Licensing, Inc., grants from ABBOTT JAPAN CO., LTD., grants from FUJIFILM Toyama Chemical Co., Ltd., outside the submitted work. Kazuaki Matsui, Hirofumi Kawakubo, Satoru Matsuda, Shuhei Mayanagi, Tomoyuki Irino, Kazumasa Fukuda, Rieko Nakamura, and Norihito Wada declare no conflict of interest.

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Matsui, K., Kawakubo, H., Matsuda, S. et al. Clinical usefulness of sputum culture on the first postoperative day to predict early postoperative pneumonia after esophagectomy for esophageal cancer. Esophagus 18, 773–782 (2021). https://doi.org/10.1007/s10388-021-00834-0

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  • DOI: https://doi.org/10.1007/s10388-021-00834-0

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