Impacts of anastomotic complications on the health‐related quality of life after esophagectomy

Zhong, Jiudi; Yang, Tianzhen; Li, Jinhui; Luo, Kongjia; Zheng, Yuzhen; Yang, Hong; Fu, Ji Anhua

doi:10.1002/jso.23837

Cited by 41 publications

(26 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A prospective cohort study demonstrated that patients who developed an anastomotic stricture after esophageal resection had significantly poorer scores of global quality of life and social function at six months after discharge in comparison with patients without anastomotic strictures [9]. So dilation up to >16 mm may result in a more rapid recovery of the quality of life to a level that is comparable with patients without anastomotic strictures.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Endoscopic dilation of benign esophageal anastomotic strictures over 16 mm has a longer lasting effect

et al. 2016

View full text Add to dashboard Cite

BackgroundThe optimal target of endoscopic dilation of postsurgical esophageal strictures is unknown. Our aim was to compare the dilation-free period of patients who underwent dilation up to 16 mm with patients who were dilated up to 17 or 18 mm.MethodsWe retrospectively analyzed adult patients who received bougie/balloon dilation for a benign anastomotic stricture after esophagectomy. An anastomotic stricture was defined as dysphagia in combination with a luminal diameter of ≤13 mm at endoscopy. We analyzed the dilation-free period using Kaplan–Meier and multivariable Cox regression analysis.ResultsEighty-eight patients were dilated up to a maximum diameter of 16 mm and 91 patients to a diameter >16 mm. The stricture recurrence rate was 79.5 % in the 16 mm group and 68.1 % in the >16 mm group (p = 0.083). The overall dilation-free period had a median of 41.5 (range 8–3233) days and 92 (range 17–1745) days, respectively (p < 0.001). For patients who developed a stricture recurrence, the median dilation-free period was 28 (range 8–487) days and 63 (range 17–1013) days, respectively (p = 0.001). Cox regression analysis showed a reduced risk of stricture recurrence for patients who were dilated up to >16 mm: crude hazard ratio (HR) 0.57 (95 % confidence interval (CI) 0.41–0.81) and adjusted HR 0.48 (95 % CI 0.33–0.70).ConclusionsEndoscopic dilation over 16 mm resulted in a significant prolongation of the dilation-free period in comparison with dilation up to 16 mm in patients with benign anastomotic strictures after esophagectomy.Electronic supplementary materialThe online version of this article (doi:10.1007/s00464-016-5187-0) contains supplementary material, which is available to authorized users.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Esophageal strictures cause complaints of dysphagia and weight loss, are associated with a decreased quality of life and lead to additional health care costs [9]. Endoscopic bougie or balloon dilation is currently the standard treatment to resolve dysphagia caused by benign esophageal strictures [10].…”

mentioning

confidence: 99%

Endoscopic dilation of benign esophageal anastomotic strictures over 16 mm has a longer lasting effect

et al. 2016

View full text Add to dashboard Cite

show abstract

“…The change in tongue pressure was not related to anastomotic leakage. The anastomotic leakage and the laryngectomy for cervical esophageal cancer are risk factors for swallowing function [29,30]. In this study, the severe cases of anastomotic leakage were excluded because they received swallowing rehabilitation and reoperation.…”

Section: Discussionmentioning

confidence: 99%

Change in tongue pressure and the related factors after esophagectomy: a short-term, longitudinal study

et al. 2019

View full text Add to dashboard Cite

Background Dysphagia is a prominent symptom after esophagectomy and may cause aspiration pneumonia. Swallowing evaluation after esophagectomy can predict and help control the incidence of postoperative pneumonia. The aim of this study was to clarify whether the change in tongue pressure was associated with any related factor and postoperative dysphagia/pneumonia in patients with esophageal cancer after esophagectomy. Methods Fifty-nine inpatients (41 males and 18 females; 33-77 years old) who underwent esophagectomy participated in this study. Measurement of tongue pressure and the repetitive saliva swallowing test (RSST) was performed before esophagectomy (baseline) and at 2 weeks postoperatively. The general data were collected from patients' medical records, including sex, age, type of cancer, cancer stage, location of cancer, operative approach, history of previous chemotherapy, surgical duration, amount of bleeding during surgery, incidences of postoperative complications, intubation period, period between surgery and initiation of oral alimentation, and intensive care unit (ICU) stay, blood chemical analysis, and lifestyle. Results Tongue pressure decreased significantly after esophagectomy (p = 0.011). The decrease of tongue pressure was significantly associated with length of ICU stay and preoperative tongue pressure on multiple regression analysis (p < 0.05). The decrease of tongue pressure in the RSST<3 or postoperative pneumonia (+) group was significantly greater than in the RSST≥3 (p = 0.003) or pneumonia (-) group (p = 0.021). Conclusions The decrease in tongue pressure was significantly associated with the length of ICU stay, preoperative tongue pressure, and the incidence of dysphagia and pneumonia among inpatient after esophagectomy.

show abstract

“…Tumors were staged according to the 7th edition of the AJCC staging system[ 11 ]. The Mckeown-type procedure was described previously[ 10 , 12 ]: first involved esophageal mobilization and radical mediastinal lymphadectomy through right thoracotomy or thoracoscopy, and then laparotomy or laparoscopic gastric mobilization. A gastric tube is fashioned with a width of approximately 4–5 cm, and pulled through retrosternal or posterior mediastinal routes to the left neck.…”

Section: Population and Methodsmentioning

confidence: 99%

“…Pulmonary complications and anastomotic leakage are the most common serious morbidities, and are great challenges to surgeons, even in experienced centers [ 8 ]. Major complications contribute to substantial perioperative mortality, and dramatically deteriorate quality of life[ 9 , 10 ]. The importance of minimizing the risk of surgical complications can never be overstated.…”

Section: Introductionmentioning

confidence: 99%

Short and Long-Term Outcomes of Epidural or Intravenous Analgesia after Esophagectomy: A Propensity-Matched Cohort Study

et al. 2016

PLoS ONE

Self Cite

View full text Add to dashboard Cite

Background and ObjectivesAs a well-established technique for postoperative pain relief, the benefits of epidural analgesia (EDA) have been under debate recently. This study aimed to determine whether EDA could improve perioperative outcomes and survival in patients undergoing esophagectomy.MethodsFrom January 2010 to December 2012, 587 consecutive cases undergoing McKeown-type esohpageactomy were retrospectively identified from a prospectively maintained database.ResultsAfter propensity-matching, incorporating baseline characteristics, 178 cases were included in each group, and patients characteristics distributions were well-balanced between two groups. Compared with intravenous analgesia, the use of EDA significantly decreased the incidence of pneumonia from 32% to 19.7% (P = 0.008), and anastomotic leakage from 23.0% to 14.0% (P = 0.029). The change in CRP level of EDA group was significantly decreased (preoperative, 6.2 vs. 6.2; POD 1, 108.1 vs. 121.3; POD 3, 131.5 vs. 137.8; POD 7, 69.3 vs. 82.1 mg/L; P = 0.044). EDA patients had a significantly longer duration of indwelling urinary catheter (P<0.001), and lower levels in both systolic (P = 0.001) and diastolic blood pressure (P<0.001). There weren't significant differences in overall survival (log-rank P = 0.47) and recurrence (Gray-test P = 0.46) between two groups.ConclusionsThese findings revealed that EDA could attenuate inflammatory response and reduce the incidence of pneumonia and anastomotic leakage after esophagectomy, at the price of delayed urinary catheter removal and lower blood pressure. EDA remains an important component of multimodal perioperative management after esophagectomy.

show abstract

Impacts of anastomotic complications on the health‐related quality of life after esophagectomy

Abstract: Postoperative HRQL is restored within 6 months after discharge. Occurrence of anastomotic stricture significantly decreases HRQL after esophagectomy.

Cited by 41 publications

References 21 publications

Endoscopic dilation of benign esophageal anastomotic strictures over 16 mm has a longer lasting effect

Endoscopic dilation of benign esophageal anastomotic strictures over 16 mm has a longer lasting effect

Change in tongue pressure and the related factors after esophagectomy: a short-term, longitudinal study

Short and Long-Term Outcomes of Epidural or Intravenous Analgesia after Esophagectomy: A Propensity-Matched Cohort Study

Contact Info

Product

Resources

About