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Risk factors for pulmonary complications after esophagectomy for esophageal cancer

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Abstract

Purpose

Pulmonary complications after esophagectomy are still common and are a major cause of mortality. The aim of this study was to clarify the risk factors for the occurrence of pulmonary complications after esophagectomy.

Methods

The clinical courses of 299 patients who underwent elective subtotal esophagectomy with lymph node dissection for esophageal cancer were retrospectively analyzed. Group I included patients who had pulmonary complications (n = 53), and group II included patients who did not (n = 246). The clinicopathological factors, surgical procedures and surgical results were compared between the groups.

Results

The frequency of any pulmonary complication was 17.7 %. Pneumonia (n = 26; 8.7 %) and respiratory failure that needed initial ventilatory support for 48 h or reintubation (n = 16; 5.4 %) were the major morbidities. The results of the logistic regression analysis suggested that smoking with a Brinkman index ≥800, salvage esophagectomy after definitive chemoradiotherapy and the amount of blood loss/body weight were independent factors associated with the occurrence of pulmonary complications.

Conclusion

Pulmonary complications after esophagectomy remain common despite advances in perioperative management. Cases with a history of heavy smoking, preoperative definitive chemoradiotherapy, and high blood loss during surgery require more careful postoperative pulmonary care.

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Conflict of interest

Naoya Yoshida and the co-authors have no conflicts of interest to declare.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuoku, Kumamoto, 860-8556, Japan

    Naoya Yoshida, Masayuki Watanabe, Yoshifumi Baba, Shiro Iwagami, Takatsugu Ishimoto, Masaaki Iwatsuki, Yasuo Sakamoto, Yuji Miyamoto, Nobuyuki Ozaki & Hideo Baba

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  1. Naoya Yoshida
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  2. Masayuki Watanabe
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  3. Yoshifumi Baba
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  4. Shiro Iwagami
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Correspondence to Hideo Baba.

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Yoshida, N., Watanabe, M., Baba, Y. et al. Risk factors for pulmonary complications after esophagectomy for esophageal cancer. Surg Today 44, 526–532 (2014). https://doi.org/10.1007/s00595-013-0577-6

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  • DOI: https://doi.org/10.1007/s00595-013-0577-6

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