We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Ivor Lewis esophagectomy patients are particularly vulnerable to respiratory impairment - a comparison to major lung resection.
- Authors
Reichert, Martin; Schistek, Magdalena; Uhle, Florian; Koch, Christian; Bodner, Johannes; Hecker, Matthias; Hörbelt, Rüdiger; Grau, Veronika; Padberg, Winfried; Weigand, Markus A.; Hecker, Andreas
- Abstract
Pulmonary complications and a poor clinical outcome are common in response to transthoracic esophagectomy, but their etiology is not well understood. Clinical observation suggests that patients undergoing pulmonary resection, a surgical intervention with similarities to the thoracic part of esophagectomy, fare much better, but this has not been investigated in detail. A retrospective single-center analysis of 181 consecutive patients after right-sided thoracotomy for either Ivor Lewis esophagectomy (n = 83) or major pulmonary resection (n = 98) was performed. An oxygenation index <300 mm Hg was used to indicate respiratory impairment. When starting surgery, respiratory impairment was seen more frequently in patients undergoing major pulmonary resection compared to esophagectomy patients (p = 0.009). On postoperative days one to ten, however, esophagectomy caused higher rates of respiratory impairment (p < 0.05) resulting in a higher cumulative incidence of postoperative respiratory impairment for patients after esophagectomy (p < 0.001). Accordingly, esophagectomy patients were characterized by longer ventilation times (p < 0.0001), intensive care unit and total postoperative hospital stays (both p < 0.0001). In conclusion, the postoperative clinical course including respiratory impairment after Ivor Lewis esophagectomy is significantly worse than that after major pulmonary resection. A detailed investigation of the underlying causes is required to improve the outcome of esophagectomy.
- Subjects
ESOPHAGECTOMY; RESPIRATORY diseases; THORACOTOMY; LUNG surgery; VENTILATION; CLINICAL trials
- Publication
Scientific Reports, 2019, Vol 9, Issue 1, pN.PAG
- ISSN
2045-2322
- Publication type
Article
- DOI
10.1038/s41598-019-48234-w