BACKGROUND: Pulmonary complications occur most frequently following a transthoracic esophagectomy for esophageal cancer and would get to be lethal occasionally. In this study, we sought to determine the effect of respiratory physiotherapy, corticosteroid administration, and the use of the video-assisted thoracoscopic (VATS) esophagectomy with a small thoracotomy incision, on the incidence of pulmonary complications following a transthoracic subtotal esophagectomy. MATERIALS AND METHODS: Approximately 184 patients who had undergone a right transthoracic subtotal esophagectomy for squamous cell carcinoma of the thoracic esophagus were studied. To reduce the incidence of pulmonary complications, we performed clinical trials using respiratory physiotherapy, corticosteroid administration, and the VATS-esophagectomy surgical technique. RESULTS: The independent risk factors for pulmonary complications in the multivariate logistic regression analysis were not administering corticosteroids, blood loss greater than 630 ml, and not providing respiratory physiotherapy. In addition, the use of a small surgical incision, less than 10 cm, for the thoracotomy had no effect on the prevention of pulmonary complications. CONCLUSIONS: We concluded that patients with thoracic esophageal cancer could undergo a three-field dissection in comparative safety if the patients were provided with corticosteroid medication in the perioperative period, if the patients received sufficient respiratory physiotherapy, and if surgical blood loss was reduced.
BACKGROUND:Pulmonary complications occur most frequently following a transthoracic esophagectomy for esophageal cancer and would get to be lethal occasionally. In this study, we sought to determine the effect of respiratory physiotherapy, corticosteroid administration, and the use of the video-assisted thoracoscopic (VATS) esophagectomy with a small thoracotomy incision, on the incidence of pulmonary complications following a transthoracic subtotal esophagectomy. MATERIALS AND METHODS: Approximately 184 patients who had undergone a right transthoracic subtotal esophagectomy for squamous cell carcinoma of the thoracic esophagus were studied. To reduce the incidence of pulmonary complications, we performed clinical trials using respiratory physiotherapy, corticosteroid administration, and the VATS-esophagectomy surgical technique. RESULTS: The independent risk factors for pulmonary complications in the multivariate logistic regression analysis were not administering corticosteroids, blood loss greater than 630 ml, and not providing respiratory physiotherapy. In addition, the use of a small surgical incision, less than 10 cm, for the thoracotomy had no effect on the prevention of pulmonary complications. CONCLUSIONS: We concluded that patients with thoracic esophageal cancer could undergo a three-field dissection in comparative safety if the patients were provided with corticosteroid medication in the perioperative period, if the patients received sufficient respiratory physiotherapy, and if surgical blood loss was reduced.
Authors: Stephen H Bailey; David A Bull; David H Harpole; Jeffrey J Rentz; Leigh A Neumayer; Theodore N Pappas; Jennifer Daley; William G Henderson; Barbara Krasnicka; Shukri F Khuri Journal: Ann Thorac Surg Date: 2003-01 Impact factor: 4.330
Authors: H Shimada; T Ochiai; S Okazumi; H Matsubara; Y Nabeya; Y Miyazawa; M Arima; Y Funami; H Hayashi; A Takeda; Y Gunji; T Suzuki; S Kobayashi Journal: Surgery Date: 2000-11 Impact factor: 3.982
Authors: James D Luketich; Miguel Alvelo-Rivera; Percival O Buenaventura; Neil A Christie; James S McCaughan; Virginia R Litle; Philip R Schauer; John M Close; Hiran C Fernando Journal: Ann Surg Date: 2003-10 Impact factor: 12.969
Authors: Michael Parker; Steven P Bowers; Ross F Goldberg; Jason M Pfluke; John A Stauffer; Horacio J Asbun; C Daniel Smith Journal: Surg Endosc Date: 2011-06-24 Impact factor: 4.584