Evaluation of Surgical Procedures that Affect the Hemodynamics Using the FloTrac System in Esophageal Cancer Patients

Abstract

Background/Aim: Esophagectomy is more invasive compared to other gastrointestinal surgery types. Perioperative circulatory management is important to avoid postoperative heart complications. The FloTrac sensor along with the Vigileo monitor is a minimally invasive haemodynamic monitoring device. Here, we examined different surgical procedures affecting hemodynamics using the FloTrac system in esophageal cancer patients following esophagectomy. Patients and Methods: Thirty-one patients undergoing postoperative monitoring with the FloTrac sensor/Vigileo monitor system following esophagectomy were included. Evaluation of cardiac index (CI) and stroke volume variation (SVV) measurements were performed by analyzing the number of aberrant values. We evaluated the correlation between the number of aberrant values of CI, SVV and surgical methods of esophagectomy and perioperative factors. Results: There was no significant correlation between the number of aberrant values of CI, SVV and operative approach or fields of lymphadenectomy. Regarding the reconstruction route following esophagectomy, there was a significant correlation between the number of aberrant values of CI, SVV and retrosternal route compared with other routes. There was a significant correlation between the number of aberrant values of SVV and preoperative heart complication. Conclusion: Hemodynamic stability management using FloTrac/Vigileo system following esophagectomy is useful for safe performance of postoperative management of esophageal cancer patients.

Postoperative hemodynamic changes for predicting anastomotic leakage after esophagectomy in patients with esophageal cancer using the FloTrac system

“…The advantage of this option is that highly valuable information can easily be obtained by the system, which is directly connected to the arterial pressure waveform. We previously reported surgical procedures that affect the hemodynamics using the FloTrac system in patients with esophageal cancer following esophagectomy (9). As a result, we demonstrated that the retrosternal route potentially influences the haemodynamic stability measured by the FloTrac / Vigileo system (9).…”

“…In addition, these results reflect that T4 cases of cancer which were judged during operation, retrosternal route significantly had been selected for getting surgery compared with other routes in this study. We previously reported the retrosternal route potentially influences the haemodynamic stability (CI or SVV) measured by the FloTrac / Vigileo system (9). We routinely select postmediastinal route in patients with esophageal cancer and R0 resection in recent year.…”

“…We previously reported surgical procedures that affect the hemodynamics using the FloTrac system in patients with esophageal cancer following esophagectomy (9). As a result, we demonstrated that the retrosternal route potentially influences the haemodynamic stability measured by the FloTrac / Vigileo system (9). Besides the consideration of previous study, we newly investigated the correlation between hemodynamic and several complications after esophagectomy in patients with esophageal cancer, using the FloTrac system.…”

“…Preoperative echocardiographic measurements of the left ventricular ejection fraction were normal in all patients. Patients with pacemakers, a history of cardiac arrhythmia, severe peripheral vascular disease along with patients who had cardiac support, persisting mitral, or aortic dysfunction after surgery were excluded (9). Furthermore, patients with preoperative treatment also were omitted.…”

“…Postoperative care and assessment of hemodynamic parameters in ICU were drawn in previous report (9). The FloTrac/ Vigileo system monitors (Edwards Lifescience, Irvine, CA, USA) CO, CI, stroke volume (SV), stroke volume index, and SVV.…”