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Respiratory complications following mini-invasive laparoscopic and thoracoscopic esophagectomy for esophageal cancer. Experience in 215 patients

INTRODUCTION: Respiratory complications (RC) including respiratory failure and adult respiratory distress syndrome (ARDS) affect the outcomes of esophagectomy substantially. In order to decrease their incidence, identification of important features of RC is necessary. AIM: To evaluate the incidence...

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Autores principales: Vrba, Radek, Vrána, David, Neoral, Čestmír, Melichar, Bohuslav, Aujeský, René, Tesarikova, Jana, Cincibuch, Jan, Zapletalová, Jana, Jínek, Tomáš, Stašek, Martin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Termedia Publishing House 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6372868/
https://www.ncbi.nlm.nih.gov/pubmed/30766629
http://dx.doi.org/10.5114/wiitm.2018.77276
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author Vrba, Radek
Vrána, David
Neoral, Čestmír
Melichar, Bohuslav
Aujeský, René
Tesarikova, Jana
Cincibuch, Jan
Zapletalová, Jana
Jínek, Tomáš
Stašek, Martin
author_facet Vrba, Radek
Vrána, David
Neoral, Čestmír
Melichar, Bohuslav
Aujeský, René
Tesarikova, Jana
Cincibuch, Jan
Zapletalová, Jana
Jínek, Tomáš
Stašek, Martin
author_sort Vrba, Radek
collection PubMed
description INTRODUCTION: Respiratory complications (RC) including respiratory failure and adult respiratory distress syndrome (ARDS) affect the outcomes of esophagectomy substantially. In order to decrease their incidence, identification of important features of RC is necessary. AIM: To evaluate the incidence and risk factors of postoperative RC following hybrid esophagectomy. MATERIAL AND METHODS: The retrospective analysis of consecutive hybrid esophagectomies for malignancies (transhiatal laparoscopic or thoracoscopic resection and limited open reconstruction phase) assessed the incidence and outcomes of RC in relation to the patients’ age, ASA score, neoadjuvant therapy, type of surgical procedure, TNM stage, the incidence of anastomotic leak and Clavien-Dindo classification. RESULTS: Transhiatal laparoscopic (176, 81.9%) or thoracoscopic hybrid esophagectomy (39, 18.1%, conversion in 7 patients) was completed in 215 patients, 187 (87%) men and 28 (13%) women. Respiratory complications developed in 86 (40%) and severe respiratory failure or ARDS occurred in 29 (13.5%) patients. The overall in-hospital mortality was 7.4%, 30-day mortality 5.6% (RC 9, myocardial infarction 1, conduit necrosis 1), and 90-day mortality a further 1.8% (multiple organ failure, ARDS). The incidence of RC correlates significantly with ASA score II and III (p = 0.0002) and Clavien-Dindo grade 4 and 5 in severe RC (p < 0.0001). Furthermore, hospital stay (p < 0.0001) and mortality (p < 0.0001) were significantly increased in RC. CONCLUSIONS: The results show a higher occurrence of RC in polymorbid patients and patients with severe complications according to the Clavien-Dindo classification. Adequate risk management including surgical technique and perioperative prophylaxis and therapy of RC should be studied and standardized.
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spelling pubmed-63728682019-02-14 Respiratory complications following mini-invasive laparoscopic and thoracoscopic esophagectomy for esophageal cancer. Experience in 215 patients Vrba, Radek Vrána, David Neoral, Čestmír Melichar, Bohuslav Aujeský, René Tesarikova, Jana Cincibuch, Jan Zapletalová, Jana Jínek, Tomáš Stašek, Martin Wideochir Inne Tech Maloinwazyjne Original Paper INTRODUCTION: Respiratory complications (RC) including respiratory failure and adult respiratory distress syndrome (ARDS) affect the outcomes of esophagectomy substantially. In order to decrease their incidence, identification of important features of RC is necessary. AIM: To evaluate the incidence and risk factors of postoperative RC following hybrid esophagectomy. MATERIAL AND METHODS: The retrospective analysis of consecutive hybrid esophagectomies for malignancies (transhiatal laparoscopic or thoracoscopic resection and limited open reconstruction phase) assessed the incidence and outcomes of RC in relation to the patients’ age, ASA score, neoadjuvant therapy, type of surgical procedure, TNM stage, the incidence of anastomotic leak and Clavien-Dindo classification. RESULTS: Transhiatal laparoscopic (176, 81.9%) or thoracoscopic hybrid esophagectomy (39, 18.1%, conversion in 7 patients) was completed in 215 patients, 187 (87%) men and 28 (13%) women. Respiratory complications developed in 86 (40%) and severe respiratory failure or ARDS occurred in 29 (13.5%) patients. The overall in-hospital mortality was 7.4%, 30-day mortality 5.6% (RC 9, myocardial infarction 1, conduit necrosis 1), and 90-day mortality a further 1.8% (multiple organ failure, ARDS). The incidence of RC correlates significantly with ASA score II and III (p = 0.0002) and Clavien-Dindo grade 4 and 5 in severe RC (p < 0.0001). Furthermore, hospital stay (p < 0.0001) and mortality (p < 0.0001) were significantly increased in RC. CONCLUSIONS: The results show a higher occurrence of RC in polymorbid patients and patients with severe complications according to the Clavien-Dindo classification. Adequate risk management including surgical technique and perioperative prophylaxis and therapy of RC should be studied and standardized. Termedia Publishing House 2018-07-24 2019-01 /pmc/articles/PMC6372868/ /pubmed/30766629 http://dx.doi.org/10.5114/wiitm.2018.77276 Text en Copyright: © 2018 Fundacja Videochirurgii http://creativecommons.org/licenses/by-nc-sa/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
spellingShingle Original Paper
Vrba, Radek
Vrána, David
Neoral, Čestmír
Melichar, Bohuslav
Aujeský, René
Tesarikova, Jana
Cincibuch, Jan
Zapletalová, Jana
Jínek, Tomáš
Stašek, Martin
Respiratory complications following mini-invasive laparoscopic and thoracoscopic esophagectomy for esophageal cancer. Experience in 215 patients
title Respiratory complications following mini-invasive laparoscopic and thoracoscopic esophagectomy for esophageal cancer. Experience in 215 patients
title_full Respiratory complications following mini-invasive laparoscopic and thoracoscopic esophagectomy for esophageal cancer. Experience in 215 patients
title_fullStr Respiratory complications following mini-invasive laparoscopic and thoracoscopic esophagectomy for esophageal cancer. Experience in 215 patients
title_full_unstemmed Respiratory complications following mini-invasive laparoscopic and thoracoscopic esophagectomy for esophageal cancer. Experience in 215 patients
title_short Respiratory complications following mini-invasive laparoscopic and thoracoscopic esophagectomy for esophageal cancer. Experience in 215 patients
title_sort respiratory complications following mini-invasive laparoscopic and thoracoscopic esophagectomy for esophageal cancer. experience in 215 patients
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6372868/
https://www.ncbi.nlm.nih.gov/pubmed/30766629
http://dx.doi.org/10.5114/wiitm.2018.77276
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