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Preoperative maximum phonation time as a predictor of pneumonia in patients undergoing esophagectomy

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Abstract

Purpose

Esophagectomy is a highly invasive procedure, associated with several postoperative complications including pneumonia, anastomotic leakage, and sepsis, which may result in multiorgan failure. Pneumonia is considered a major predictor of poor long-term prognosis, so its prevention is important for patients undergoing surgery for esophageal cancer.

Methods

The subjects of this study were 137 patients who underwent esophagectomy at Keio University Hospital, Tokyo, Japan, between January, 2012 and December, 2016. Patients who underwent R0 or R1 resection or esophagectomy with organ excision were included. Patients who underwent salvage surgery or resection of recurrent laryngeal nerve, and those with preoperative recurrent laryngeal nerve palsy, were excluded. We investigated the effect of the maximum phonation time on the development of postoperative pneumonia.

Results

Pneumonia developed more frequently in patients with a long operative time, clinically left recurrent nerve lymph node metastasis, and a short preoperative maximum phonation time (p = 0.074, 0.046, and 0.080, respectively). Pneumonia was also more common in men with an abnormal maximum phonation time (p = 0.010).

Conclusions

The maximum phonation time is a significant predictor of postoperative pneumonia after esophagectomy in men.

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Acknowledgements

We thank Kumiko Motooka, from the Department of Surgery in Keio University School of Medicine, for her help with the preparation of this report.

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Authors and Affiliations

  1. Department of Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan

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

  2. Clinical and Translational Research Center, Keio University Hospital, Shinjuku-ku, Tokyo, Japan

    Ryo Takemura

  3. Department of Rehabilitation Medicine, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan

    Aiko Ishikawa, Ayako Wada & Tetsuya Tsuji

  4. Department of Rehabilitation Medicine, Keio University Hospital, Shinjuku-ku, Tokyo, Japan

    Makiko Ando

Authors
  1. Hiroki Ozawa
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  2. Hirofumi Kawakubo
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Corresponding author

Correspondence to Hirofumi Kawakubo.

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We have no conflicts of interest to declare.

Ethical approval

All procedures were followed in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and its later versions. Informed consent or a substitute for it was obtained from all patients included in the study.

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Ozawa, H., Kawakubo, H., Matsuda, S. et al. Preoperative maximum phonation time as a predictor of pneumonia in patients undergoing esophagectomy. Surg Today 52, 1299–1306 (2022). https://doi.org/10.1007/s00595-022-02454-2

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  • DOI: https://doi.org/10.1007/s00595-022-02454-2

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