Preoperative risk analysis—a reliable predictor of postoperative outcome after transthoracic esophagectomy?

Abstract

Preoperative risk analysis in particular pulmonary function and general status helps to select patients for transthoracic esophagectomy to reduce postoperative morbidity.

Esophageal Cancer Specific Risk Score Is Associated with Postoperative Complications Following Open Ivor-Lewis Esophagectomy for Adenocarcinoma

“…For assessment of the individual preoperative risk, we used the 'preoperative risk analysis' published by Schröder et al [18] . This score includes the general state of health as well as several organ functions.…”

“…These scores include the physiological condition of the patient and/or details of the perioperative course. Most interestingly, there are also a few risk scores that had been developed especially for esophageal cancer patients such as the O-POSSUM score (a modified POSSUM score) [17] and the risk score of Schröder et al [18] .…”

“…With the current study, we aimed to compare the individual patient's risk as assessed by the classification according to Schröder et al [18] with the severity of perioperative complications as assessed by the Dindo classification in this patient group. We chose the subpopulation of adenocarcinoma patients in order to investigate if a preoperative risk score can predict complex perioperative complications, what might help improving outcome of esophageal adenocarcinoma patients by either better selection or preoperative conditioning.…”

Road Map to Esophagectomy for Nurses

“…If the margins are not clear, more resection is needed. 26,27 The upper part of the esophagus is now attached to the fundus of the stomach by using a stapler or hand suturing. This process restores continuity between the oral cavity and the stomach.…”

Society for Translational Medicine Expert Consensus on the prevention and treatment of postoperative pulmonary infection in esophageal cancer patients

“…in respiratory secretions, serum and other body fluids using immunological methods (i.e., immunofluorescence assay) or histopathological analysis. Although many scholars have attempted to establish a scoring system for admission to the intensive care unit (ICU) after esophageal cancer surgery, specific criteria for ICU admission has not been widely accepted (13)(14)(15)(16). Risk factors associated with postoperative ICU admission include the presence of preoperative COPD, higher American Society of Anesthesiologist (ASA) scores, large intraoperative blood transfusion, postoperative neurological dysfunction (which might be closely associated with the occurrence of postoperative sepsis), and cardiac arrhythmias (17,18 3-4 associated with or without lymph node metastasis); however, the dose should not be too high and should be controlled within the 50 Gy range.…”