Esophagus

, Volume 5, Issue 2, pp 81–86 | Cite as

Estimation of Physiologic Ability and Surgical Stress (E-PASS system) in patients with esophageal squamous cell carcinoma undergoing resection

  • Yoshifumi Baba
  • Yoshio Haga
  • Yukiharu Hiyoshi
  • Yu Imamura
  • Youhei Nagai
  • Naoya Yoshida
  • Naoko Hayashi
  • Eiichirou Toyama
  • Nobutomo Miyanari
  • Hideo Baba
Original Article
First Online:
Received:
Accepted:

Abstract

Background

The Estimation of Physiologic Ability and Surgical Stress (E-PASS) scoring system was designed on the hypothesis that the balance between the patient’s physiological reverse capacity and the surgical stress of operation was important in the development of postoperative complications. The aim of this study was to evaluate whether the E-PASS scoring system could predict the occurrence of complications after elective esophagectomy for esophageal cancer, including salvage esophagectomy.

Methods

E-PASS predictor equations were applied retrospectively to 142 patients who had undergone esophagectomy for esophageal squamous cell carcinoma [110 patients without preoperative chemoradiotherapy (CRT), 15 patients with neoadjuvant CRT followed by planned esophagectomy, and 17 patients with definitive CRT followed by salvage esophagectomy]. The incidence rates of postoperative complications were compared with the preoperative risk score (PRS), surgical stress score (SSS), and comprehensive risk score (CRS) of the E-PASS scoring system.

Results

Of the 142 patients, 43 (30%) had postoperative complications. The incidence of postoperative complications increased as the CRS score increased. Patients with a CRS > 1.0 were at a particularly high risk of postoperative complications. Definitive CRT increased the incidence of postoperative complications, and the SSS and CRS of patients with definitive CRT were significantly higher than those of patients without preoperative CRT or with neoadjuvant CRT.

Conclusions

The E-PASS scoring system was useful in predicting complications after elective esophagectomy for esophageal cancer. The SSS of the E-PASS scoring system could also reflect the maximum invasiveness of salvage esophagectomy.

Key words

E-PASS scoring system Esophageal cancer Complications Salvage operation 
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Copyright information

© Japan Esophageal Soceity and Springer Japan 2008

Authors and Affiliations

  • Yoshifumi Baba
    • 1
  • Yoshio Haga
    • 2
    • 3
  • Yukiharu Hiyoshi
    • 1
  • Yu Imamura
    • 1
  • Youhei Nagai
    • 1
  • Naoya Yoshida
    • 1
  • Naoko Hayashi
    • 1
  • Eiichirou Toyama
    • 1
  • Nobutomo Miyanari
    • 1
  • Hideo Baba
    • 1
  1. 1.Department of Gastroenterological Surgery, Graduate School of Medical SciencesKumamoto UniversityKumamotoJapan
  2. 2.Department of Surgery, National Hospital OrganizationKumamoto Medical CenterKumamotoJapan
  3. 3.Department of International Medical Cooperation, Graduate School of Medical SciencesKumamoto UniversityKumamotoJapan

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