Ivor Lewis esophagectomy patients are particularly vulnerable to respiratory impairment - a comparison to major lung resection
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 esophage...
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| Main Authors: | , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
14 August 2019
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| In: |
Scientific reports
Year: 2019, Volume: 9, Pages: 1-12 |
| ISSN: | 2045-2322 |
| DOI: | 10.1038/s41598-019-48234-w |
| Online Access: | Verlag, Volltext: https://doi.org/10.1038/s41598-019-48234-w Verlag: https://www.nature.com/articles/s41598-019-48234-w 
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| Author Notes: | Martin Reichert, Magdalena Schistek, Florian Uhle, Christian Koch, Johannes Bodner, Matthias Hecker, Rüdiger Hörbelt, Veronika Grau, Winfried Padberg, Markus A. Weigand & Andreas Hecker |
| Summary: | 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. |
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| Item Description: | Gesehen am 06.12.2019 |
| Physical Description: | Online Resource |
| ISSN: | 2045-2322 |
| DOI: | 10.1038/s41598-019-48234-w |