Predictive Factors for Postoperative Pulmonary Complications and Mortality After Esophagectomy for Cancer

• DOI: 10.1097/01.sla.0000143123.24556.1c
• Publication Date: 2004-10-15T08:01:18Z
• Authors: Simon Law; Kam-Ho Wong; Ka-Fai Kwok; Kent-Man Chu; John Wong
• Keywords: Esophagectomy; Neoadjuvant Therapy; Chemoradiotherapy

This study aimed at: (1) documenting the evolution of surgical results esophagectomy in a high-volume center, (2) identifying predictive factors pulmonary complications and mortality, (3) examining whether preoperative chemoradiation therapy would complicate postoperative recovery.Pulmonary mortality rate after remain substantial, responsible have not been adequately studied. Neoadjuvant is widely used; it hypothesized that this may lead to adverse outcome.Prospectively collected data were used analyze outcome 421 patients with intrathoracic squamous cell esophageal cancer who underwent resection. Logistic regression analyses determined independent predictors death. Two time periods compared: period I (January 1990 June 1995) II (July 1995 December 2001). In later period, neoadjuvant was introduced.Transthoracic resections carried out 83% patients. given 42% II. Major occurred 15.9%, primarily for 55% hospital deaths. Thirty-day rates 1.4% 4.8%, respectively. analysis identified age, operation duration, proximal tumor location as risk complications, whereas advanced age higher blood loss mortality. Chemoradiation did worse outcome. When compared, reduced from 7.8% 1.1%, P = 0.001, correspondingly less (median 700 ml (range: 200-2700 (period I) 450 100-7000) II), < 0.01).A 1.1% achieved last 6 years period. Preoperative result Reduction correlated decreased loss.