Ryo Kato1, Tomoki Makino2, Makoto Yamasaki1, Koji Tanaka1, Yasuhiro Miyazaki3, Tsuyoshi Takahashi1, Yukinori Kurokawa1, Masaaki Motoori3, Yutaka Kimura4, Kiyokazu Nakajima1, Masaki Mori5, Yuichiro Doki1. 1. Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2-E2, Yamada-oka, Suita, Osaka, 565-0871, Japan. 2. Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2-E2, Yamada-oka, Suita, Osaka, 565-0871, Japan. tmakino@gesurg.med.osaka-u.ac.jp. 3. Department of Surgery, Osaka General Medical Center, Osaka, Japan. 4. Department of Surgery, Kindai University Faculty of Medicine, Osaka, Japan. 5. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Abstract
PURPOSE: Prolonged chest drain placement can extend the postoperative hospital stay after esophagectomy in esophageal cancer (EC) patients. This study aimed to identify whether or not the risk factors associated with this prolonged chest tube placement are clinically important. METHODS: A total of 138 patients who underwent subtotal esophagectomy for thoracic EC were retrospectively analyzed. Using the 75th percentile of the total drainage volume of chest tubes as a cutoff value, the high-output (HO; n = 35) and low-output (LO; n = 103) groups were compared in terms of the clinicopathological parameters. RESULTS: The median durations of right and left chest tube placement were 6 and 9 days, respectively, with a median total drainage volume of 2692 ml. When compared with the LO group, the HO group was significantly associated with male gender, a subcutaneous route for reconstruction, blood transfusion, higher morbidity, and prolonged chest drainage and postoperative hospital stays. A multivariable analysis further identified blood loss (p = 0.03) and the subcutaneous route for reconstruction (p = 0.04) as independent risk factors for increased chest tube drainage after esophagectomy. CONCLUSION: Blood loss and the subcutaneous route of reconstruction are risk factors for increased drainage of chest tube after esophagectomy for EC.
PURPOSE: Prolonged chest drain placement can extend the postoperative hospital stay after esophagectomy in esophageal cancer (EC) patients. This study aimed to identify whether or not the risk factors associated with this prolonged chest tube placement are clinically important. METHODS: A total of 138 patients who underwent subtotal esophagectomy for thoracic EC were retrospectively analyzed. Using the 75th percentile of the total drainage volume of chest tubes as a cutoff value, the high-output (HO; n = 35) and low-output (LO; n = 103) groups were compared in terms of the clinicopathological parameters. RESULTS: The median durations of right and left chest tube placement were 6 and 9 days, respectively, with a median total drainage volume of 2692 ml. When compared with the LO group, the HO group was significantly associated with male gender, a subcutaneous route for reconstruction, blood transfusion, higher morbidity, and prolonged chest drainage and postoperative hospital stays. A multivariable analysis further identified blood loss (p = 0.03) and the subcutaneous route for reconstruction (p = 0.04) as independent risk factors for increased chest tube drainage after esophagectomy. CONCLUSION:Blood loss and the subcutaneous route of reconstruction are risk factors for increased drainage of chest tube after esophagectomy for EC.
Entities:
Keywords:
Esophageal cancer; Esophagectomy; Thoracic surgery
Authors: Kevin W A Göttgens; Jan Siebenga; Eric H J Belgers; Pieter-Jan van Huijstee; Ewald C M Bollen Journal: Eur J Cardiothorac Surg Date: 2010-09-15 Impact factor: 4.191
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Authors: K Yamashita; T Makino; M Yamasaki; K Tanaka; T Hara; Y Miyazaki; T Takahashi; Y Kurokawa; K Nakajima; S Takiguchi; M Mori; Y Doki Journal: Dis Esophagus Date: 2017-11-01 Impact factor: 3.429