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Risk Factors for Postoperative Pneumonia After Esophagectomy for Esophageal Cancer

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Abstract

Few studies have investigated the risk factors for postoperative pneumonia after esophageal cancer surgery. The aim of the present study was to identify risk factors of postoperative pneumonia after esophagectomy for esophageal cancer. This study included 122 patients who underwent curative surgery for esophageal cancer between January 2005 and September 2018. The rate of postoperative pneumonia was measured by the revised Uniform Pneumonia Score. Univariate and multivariate logistic regression analyses were performed to identify the risk factors for postoperative pneumonia. Postoperative pneumonia was found in 34 of the 122 patients (27.9%). Among the factors examined (age, gender, preoperative chemotherapy status, operative type, operative duration, blood loss, lymph node dissection, smoking habit, and alcohol habit), the age (p = 0.038) and operative duration (p = 0.035) were identified as significant independent risk factors for postoperative pneumonia in the univariate and multivariate analyses. The incidence of postoperative pneumonia was 40% (22 of 55) in patients ≥ 70 years old and 17.9% (12 of 67) in those < 70 years old. The incidence of postoperative pneumonia was 45.2% (28 of 62) in the operative duration ≥ 570 min group and 10.0% (6 of 60) in the operative duration < 570 min group. The age and operative duration were risk factors for postoperative pneumonia in patients who underwent curative esophagectomy for esophageal cancer. To improve the survival of patients with esophageal cancer, it is necessary to carefully plan the surgical procedure, perioperative care, and surgical strategy.

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References

  1. Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A (2015) Global cancer statistics, 2012. CA Cancer J Clin 65:87–108

    Article  Google Scholar 

  2. NCCN. NCCN Clinical Practice Guidelines in Oncology. https://www.nccn.org/professionals/physician_gls/default.aspx. Accessed 1 Apr 2019

  3. Lordick F, Mariette C, Haustermans K, Obermannová R, Arnold D, ESMO guidelines committee (2016) Oesophageal cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 27:v50–v57

    Article  CAS  Google Scholar 

  4. Biere SS, van Berge Henegouwen MI, Maas KW, Bonavina L, Rosman C, Garcia JR, Gisbertz SS, Klinkenbijl JH, Hollmann MW, de Lange ES, Bonjer HJ, van der Peet DL, Cuesta MA (2012) Minimally invasive versus open oesophagectomy for patients with oesophageal cancer: a multicentre, open-label, randomised controlled trial. Lancet. 379:1887–1892

    Article  Google Scholar 

  5. Mantziari S, Hübner M, Demartines N, Schäfer M (2014) Impact of preoperative risk factors on morbidity after esophagectomy: is there room for improvement? World J Surg 38:2882–2890

    Article  Google Scholar 

  6. Dhungel B, Diggs BS, Hunter JG, Sheppard BC, Vetto JT, Dolan JP (2010) Patient and peri-operative predictors of morbidity and mortality after esophagectomy: American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP), 2005-2008. J Gastrointest Surg 14:1492–1501

    Article  Google Scholar 

  7. Kataoka K, Takeuchi H, Mizusawa J, Igaki H, Ozawa S, Abe T, Nakamura K, Kato K, Ando N, Kitagawa Y (2017) Prognostic impact of postoperative morbidity after esophagectomy for esophageal cancer: exploratory analysis of JCOG9907. Ann Surg 265:1152–1157

    Article  Google Scholar 

  8. Booka E, Takeuchi H, Nishi T et al (2015) The impact of postoperative complications on survivals after esophagectomy for esophageal cancer. Medicine (Baltimore) 94:e1369

    Article  Google Scholar 

  9. Cassidy MR, Rosenkranz P, McCabe K, Rosen JE, McAneny D (2013) I COUGH: reducing postoperative pulmonary complications with a multidisciplinary patient care program. JAMA Surg 148:740–745

    Article  Google Scholar 

  10. Miki Y, Makuuchi R, Honda S, Tokunaga M, Tanizawa Y, Bando E, Kawamura T, Yurikusa T, Tanuma A, Terashima M (2018) Prospective phase II study evaluating the efficacy of swallow ability screening tests and pneumonia prevention using a team approach for elderly patients with gastric cancer. Gastric Cancer 21:353–359

    Article  CAS  Google Scholar 

  11. Atkins BZ, D’Amico TA (2006) Respiratory complications after esophagectomy. Thorac Surg Clin 16:35–48

    Article  Google Scholar 

  12. Ferguson MK, Durkin AE (2002) Preoperative prediction of the risk of pulmonary complications after esophagectomy for cancer. J Thorac Cardiovasc Surg 123:661–669

    Article  Google Scholar 

  13. Blencowe NS, Strong S, McNair AG, Brookes ST, Crosby T, Griffin SM et al (2012) Reporting of short-term clinical outcomes after esophagectomy: a systematic review. Ann Surg 255:658–666

    Article  Google Scholar 

  14. Ferguson MK, Celauro AD, Prachand V (2011) Prediction of major pulmonary complications after esophagectomy. Ann Thorac Surg 91:1494–1500

    Article  Google Scholar 

  15. Paul DJ, Jamieson GG, Watson DI, Devitt PG, Game PA (2011) Perioperative risk analysis for acute respiratory distress syndrome after elective oesophagectomy. ANZ J Surg 81:700–706

    Article  Google Scholar 

  16. Zingg U, Smithers BM, Gotley DC, Smith G, Aly A, Clough A, Esterman AJ, Jamieson GG, Watson DI (2011) Factors associated with postoperative pulmonary morbidity after esophagectomy for cancer. Ann Surg Oncol 18:1460–1468

    Article  Google Scholar 

  17. Valkenet K, Trappenburg JCA, Ruurda JP, Guinan EM, Reynolds JV, Nafteux P, Fontaine M, Rodrigo HE, van der Peet DL, Hania SW, Sosef MN, Willms J, Rosman C, Pieters H, Scheepers JJG, Faber T, Kouwenhoven EA, Tinselboer M, Räsänen J, Ryynänen H, Gosselink R, van Hillegersberg R, Backx FJG (2018) Multicentre randomized clinical trial of inspiratory muscle training versus usual care before surgery for oesophageal cancer. Br J Surg 105:502–511

    Article  CAS  Google Scholar 

  18. Voskoboinik A, Costello BT, Kalman E, Prabhu S, Sugumar H, Wong G, Nalliah C, Ling LH, McLellan A, Hettige T, Springer F, La Gerche A, Kalman JM, Taylor AJ, Kistler PM (2018) Regular alcohol consumption is associated with impaired atrial mechanical function in the atrial fibrillation population: a cross-sectional MRI-based study. JACC Clin Electrophysiol 4:1451–1459

    Article  Google Scholar 

  19. Molena D, Mungo B, Stem M, Lidor AO (2014) Incidence and risk factors for respiratory complications in patients undergoing esophagectomy for malignancy: a NSQIP analysis. Semin Thorac Cardiovasc Surg 26:287–294

    Article  Google Scholar 

  20. Law S, Wong KH, Kwok KF, Chu KM, Wong J (2004) Predictive factors for postoperative pulmonary complications and mortality after esophagectomy for cancer. Ann Surg 240:791–800

    Article  Google Scholar 

  21. Soutome S, Yanamoto S, Funahara M, Hasegawa T, Komori T, Yamada SI, Kurita H, Yamauchi C, Shibuya Y, Kojima Y, Nakahara H, Oho T, Umeda M (2017) Effect of perioperative oral care on prevention of postoperative pneumonia associated with esophageal cancer surgery: a multicenter case-control study with propensity score matching analysis. Medicine (Baltimore) 96:e7436. https://doi.org/10.1097/MD.0000000000007436

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan

    Ayako Tamagawa, Toru Aoyama, Hiroshi Tamagawa, Mihwa Ju, Masakatsu Numata, Norio Yukawa, Munetaka Masuda & Yasushi Rino

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  1. Ayako Tamagawa
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  2. Toru Aoyama
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  3. Hiroshi Tamagawa
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  4. Mihwa Ju
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  5. Masakatsu Numata
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  6. Norio Yukawa
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  7. Munetaka Masuda
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  8. Yasushi Rino
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Correspondence to Toru Aoyama.

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This study was approved by the IRB Committee of Yokohama City University.

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The authors declare that they have no conflict of interest.

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Tamagawa, A., Aoyama, T., Tamagawa, H. et al. Risk Factors for Postoperative Pneumonia After Esophagectomy for Esophageal Cancer. Indian J Surg 82, 632–638 (2020). https://doi.org/10.1007/s12262-020-02080-7

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  • DOI: https://doi.org/10.1007/s12262-020-02080-7

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