Ivor Lewis esophagectomy patients are particularly vulnerable to respiratory impairment - a comparison to major lung resection

• Verfasst von: Reichert, Martin [VerfasserIn]
• Verfasst von: Schistek, Magdalena [VerfasserIn]
• Verfasst von: Uhle, Florian [VerfasserIn]
• Verfasst von: Koch, Christian [VerfasserIn]
• Verfasst von: Bodner, Johannes [VerfasserIn]
• Verfasst von: Hecker, Matthias [VerfasserIn]
• Verfasst von: Hörbelt, Rüdiger [VerfasserIn]
• Verfasst von: Grau, Veronika [VerfasserIn]
• Verfasst von: Padberg, Winfried [VerfasserIn]
• Verfasst von: Weigand, Markus A. [VerfasserIn]
• Verfasst von: Hecker, Andreas [VerfasserIn]
• Titel: Ivor Lewis esophagectomy patients are particularly vulnerable to respiratory impairment - a comparison to major lung resection
• Verf.angabe: Martin Reichert, Magdalena Schistek, Florian Uhle, Christian Koch, Johannes Bodner, Matthias Hecker, Rüdiger Hörbelt, Veronika Grau, Winfried Padberg, Markus A. Weigand & Andreas Hecker
• E-Jahr: 2019
• Jahr: 14 August 2019
• Umfang: 12 S.
• Fussnoten: Gesehen am 06.12.2019
• Titel Quelle: Enthalten in: Scientific reports
• Ort Quelle: [London] : Macmillan Publishers Limited, part of Springer Nature, 2011
• Jahr Quelle: 2019
• Band/Heft Quelle: 9(2019) Artikel-Nummer 11856, 12 Seiten
• ISSN Quelle: 2045-2322
• DOI: doi:10.1038/s41598-019-48234-w
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1684688434

Abstract

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.