Literature DB >> 26941977

The dynamic of nasogastric decompression after esophagectomy and its predictive value of postoperative complications.

Yan Zhao1, Jie Guo1, Bin You1, Shengcai Hou1, Bin Hu1, Hui Li1.   

Abstract

BACKGROUND: To investigate the regularity and the influence factors of nasogastric decompression volume after esophagectomy, and explore whether the volume of nasogastric decompression can be employed as a predictor for postoperative complications of esophageal carcinoma.
METHODS: Consecutive 247 patients with esophageal cancer who underwent esophagectomy were retrospectively evaluated. The volume of postoperative nasogastric decompression was recorded and the regularity based on it was described. The single and multiple factors regression analysis were used to find out relative factors of the nasogastric decompression volume among the patients without postoperative complication. Gender, age, height, weight, tobacco or alcohol exposure, location of the tumor, histological type, pathological staging, operation time, surgical procedures, anastomotic position and gastric conduit reconstruction were considered as the independent variable. Then, verify the former regression models using the data of patients with postoperative complications.
RESULTS: In trend analysis, the curve estimation revealed a quadratic trend in the relationship between nasogastric decompression volume and postoperative days (R(2) =0.890, P=0.004). The volume of postoperative nasogastric decompression was described by daily drainage (mL) =82.215 + 69.620 × days - 6.604 × days(2). The results of multiple linear stepwise regression analysis showed that gastric conduit reconstruction (β=0.410, P=0.000), smoking (β=-0.231, P=0.000), age (β=-0.193, P=0.001) and histological type of the tumor (β=-0.169, P=0.006) were significantly related to the volume of nasogastric decompression. The average drainage in 5 days after surgery =262.287 + 132.873 × X1 - 72.160 × X2 - 27.904 × X3 - 36.368 × X4 (X1, gastric conduit reconstruction; X2, smoking; X3, histological type; X4, age). The nasogastric decompression of the patients with delayed gastric emptying, and lung infection statistically differ from their predictive values respectively according to the former equation (P<0.01), but the data of anastomotic leakage cases had no significance difference (P=0.344).
CONCLUSIONS: It is found that the volume of postoperative nasogastric decompression presents a quadratic trend based on the days after esophagectomy. Gastric conduit reconstruction, smoking history, age and histological type were independent factors affecting on the volume of postoperative nasogastric decompression. Also, the volume of nasogastric decompression has validity and application value for predicting postoperative complications.

Entities:  

Keywords:  Esophageal cancer; esophagectomy; nasogastric decompression; postoperative complications

Year:  2016        PMID: 26941977      PMCID: PMC4756234          DOI: 10.3978/j.issn.2072-1439.2015.10.72

Source DB:  PubMed          Journal:  J Thorac Dis        ISSN: 2072-1439            Impact factor:   2.895


  21 in total

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7.  Postoperative pulmonary complications are associated with worse short- and long-term outcomes after extended esophagectomy.

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10.  Postoperative complications after transthoracic esophagectomy for cancer of the esophagus and gastroesophageal junction are correlated with early cancer recurrence: role of systematic grading of complications using the modified Clavien classification.

Authors:  Toni Lerut; Johnny Moons; Willy Coosemans; Dirk Van Raemdonck; Paul De Leyn; Herbert Decaluwé; Georges Decker; Philippe Nafteux
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