Journalartikel

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


AutorenlisteReichert, Martin; Schistek, Magdalena; Uhle, Florian; Koch, Christian; Bodner, Johannes; Hecker, Matthias; Hoerbelt, Ruediger; Grau, Veronika; Padberg, Winfried; Weigand, Markus A.; Hecker, Andreas

Jahr der Veröffentlichung2019

ZeitschriftScientific Reports

Bandnummer9

ISSN2045-2322

Open Access StatusGold

DOI Linkhttps://doi.org/10.1038/s41598-019-48234-w

VerlagNature Research


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.



Zitierstile

Harvard-ZitierstilReichert, M., Schistek, M., Uhle, F., Koch, C., Bodner, J., Hecker, M., et al. (2019) Ivor Lewis esophagectomy patients are particularly vulnerable to respiratory impairment - a comparison to major lung resection, Scientific Reports, 9, Article 11856. https://doi.org/10.1038/s41598-019-48234-w

APA-ZitierstilReichert, M., Schistek, M., Uhle, F., Koch, C., Bodner, J., Hecker, M., Hoerbelt, R., Grau, V., Padberg, W., Weigand, M., & Hecker, A. (2019). Ivor Lewis esophagectomy patients are particularly vulnerable to respiratory impairment - a comparison to major lung resection. Scientific Reports. 9, Article 11856. https://doi.org/10.1038/s41598-019-48234-w



Schlagwörter


ASSISTED THORACOSCOPIC SURGERYDISTRESS-SYNDROMEMINIMALLY INVASIVE ESOPHAGECTOMYmorbidityPOSTOPERATIVE PULMONARY COMPLICATIONSSHORT-TERM


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