Risk factors and measures of pulmonary complications after thoracoscopic esophagectomy for esophageal cancer
Postoperative pulmonary complications (PCs) after thoracoscopic esophagectomy for esophageal cancer (EC) still occur too frequently. We conducted this study to identify the risk factors for PCs developing in EC patients who undergo thoracoscopic esophagectomy.
The subjects of this retrospective study were 89 patients with EC who underwent thoracoscopic esophagectomy in our department between January 2010 and December 2015. Univariate and multivariate logistic regression analyses were used to evaluate the association between the incidence of PC and clinical factors. In January 2016, we introduced a new prophylactic intervention for reducing the incidence of delirium and assessed its significance for PCs.
PCs developed in 19 patients (21.3%). Univariate analysis revealed the following risk factors: age (> 69 years), ratio of the forced expiratory volume in 1 s to forced vital capacity (< 70%), chronic obstructive pulmonary disease (COPD), and postoperative delirium. Multivariate analysis found that COPD and postoperative delirium were independent risk factors for PCs. Our new intervention for delirium significantly reduced its occurrence (p = 0.00004) and also the frequency of PCs (p = 0.04148).
Postoperative delirium and COPD were risk factors for PCs in patients who underwent thoracoscopic esophagectomy. Our intervention study showed clearly that reducing the occurrence of postoperative delirium could decrease the incidence of PCs.
KeywordsEsophageal cancer Thoracoscopic esophagectomy Pulmonary complications Delirium
Compliance with ethical standards
Conflict of interest
We have no conflicts of interest and received no financial support for this study.
All procedures and subsequent analyses were performed with the approval of the Institutional Review Boards of Mie University Hospital in Japan (no. 2017-3203). The study was conducted in accordance with the guidelines of the 1975 Declaration of Helsinki. Written informed consent was obtained from all study participants.
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