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. 2012 Apr 1;3(4):907-912.
doi: 10.3892/ol.2012.589. Epub 2012 Feb 1.

Risk factors for postoperative respiratory complications following esophageal cancer resection

Atsushi Shiozaki  1 , Hitoshi Fujiwara, Hiroko Okamura, Yasutoshi Murayama, Shuhei Komatsu, Yoshiaki Kuriu, Hisashi Ikoma, Masayoshi Nakanishi, Daisuke Ichikawa, Kazuma Okamoto, Toshiya Ochiai, Yukihito Kokuba, Eigo Otsuji
Affiliations

Risk factors for postoperative respiratory complications following esophageal cancer resection

Atsushi Shiozaki et al. Oncol Lett. .

Abstract

The development of surgical and postoperative management techniques has improved the treatment outcomes of esophageal cancer resection. However, respiratory morbidity is still the most frequent complication after esophagectomy. The objective of the present study was to identify risk factors for respiratory complications following resection for esophageal cancer. This study included 96 patients with esophageal cancer who had undergone esophagectomy with lymph node dissection. The patients were divided into 2 groups according to the presence (20 patients, 17 had pneumonia and 3 had acute respiratory distress syndrome) or absence (76 patients) of postoperative respiratory complications (PRC). The two groups were compared with respect to their preoperative clinical variables, such as age, body mass index, smoking history, serum albumin, serum C-reactive protein (CRP), number of lymphocytes, %VC, FEV1.0% and FEV1.0. Furthermore, multiple logistic regression analyses were used to estimate relative risk factors for respiratory complications. Results of the univariate analysis showed that smoking history (+/-, patients with PRC, 19/1 and without PRC, 53/23), serum CRP (≥1.0 mg/dl/<1.0 mg/dl, patients with PRC, 6/14 and without PRC, 6/70) and FEV1.0% (≥60%/<60%, patients with PRC, 16/4 and without PRC, 73/3) were significantly different between the two groups. Multiple logistic regression analysis showed that FEV1.0% was the strongest predictor of PRC. FEV1.0%, serum CRP and smoking history are reliable predictors of the risk of respiratory complications following esophageal cancer resection. For patients with these factors, perioperative management for the prevention of postoperative respiratory complications should be considered.

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Figures

Table I
Table I
Postoperative respiratory complications of 96 patients who underwent esophagectomy.
Table II
Table II
Comparison of clinicopathological backgrounds between patients with and without postoperative respiratory complications.
Figure 1
Figure 1
Comparison of the duration of respiratory management following surgery between patients with and without postoperative respiratory complications (PRC). The period of respiratory management after esophagectomy was significantly longer in patients with PRC. Mean ± SEM. *P<0.05 was considered to indicate a statistically significant result.
Table III
Table III
Comparison of preoperative clinical parameters between patients with and without postoperative respiratory complications.
Table IV
Table IV
Results of the multiple logistic regression analysis using the presence of postoperative respiratory complications as the dependent variable.
See this image and copyright information in PMC

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