Risk factors and therapeutic measures for postoperative complications associated with esophagectomy

Ahmadinejad, Mojtaba; Soltanian, Ali Reza; Maghsoudi, Leila Haji

doi:10.1016/j.amsu.2020.05.011

Cited by 10 publications

(9 citation statements)

References 97 publications

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“…We will divide patients into two groups according to whether the patients are known to have high-risk factors (operation time greater than 2 hours, preoperative airway problems, smoking 8 weeks before surgery, ASA score 3–5 points by American Society of Anesthesiologists7 8) and whether the patients used intraoperative one-lung ventilation during the operation. The incidence of seven types of PPCs will also be counted separately.…”

Section: Methods and Analysismentioning

confidence: 99%

“…PPC is associated with significantly increased early postoperative mortality, intensive care unit (ICU) admission and prolonged length of stay in the ICU and hospital 2–4. For patients undergone thoracic surgery, mechanical ventilation strategies, analgesia and sedation, the use of muscle relaxants during the operation and the withdrawal of mechanical ventilation-mediated positive pressure postoperatively may cause or exacerbate the occurrence of PPCs 3–8. Numerous clinical studies have examined preoperative risk assessment and prevention strategies8–11 and the impact of intraoperative muscle relaxants and mechanical ventilation strategies on PPCs 5 12–16…”

Section: Introductionmentioning

confidence: 99%

“…PPCs are currently believed to be caused by multifarious factors, including surgical pneumonectomy, intraoperative lung isolation techniques, alveolar collapse caused by insufficient positive end-expiratory pressure (PEEP) or other reasons, restricted breathing and decreased cough ability after surgery, small airway obstruction generated by reduced airway cilia movement, blocking secretions caused by analgesia and sedative drugs, and the inhalation of pure oxygen 6–8. Corresponding preventative and curative strategies, such as using intermittent lung recruitment manoeuvre (RM) intraoperatively and pharmacological reversal, have also been proposed.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Recruitmentmanoeuvres during mechanical ventilation with sequential high-flow nasal oxygen after extubation to prevent postoperative pulmonary complications in patients undergone thoracic surgery: a protocol, prospective randomised controlled trial

Wang

Xia

et al. 2022

BMJ Open

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IntroductionThe incidence of postoperative pulmonary complications (PPCs) following thoracic surgery is high, which increases the mortality rate, prolongs the length of hospital stay and increases medical costs. Some studies have confirmed that preoperative risk assessment, intraoperative anaesthesia methods and intraoperative mechanical ventilation strategies, including recruitment manoeuvres (RMs), can reduce the incidence of PPCs. Despite these improved strategies, the incidence of PPCs remains high. However, mechanical ventilation strategies have not been studied in the postoperative period.Methods and analysisWe assume that RM during mechanical ventilation with sequential high-flow nasal oxygen therapy (HFNO) after extubation can maintain the opening of the postoperative alveoli and ultimately reduce the incidence of PPCs after thoracic surgery. We will include thoracic surgery patients and divide them into the RM with sequential HFNO group and the control group. They will be given RMs and sequential HFNO or be given conventional treatment. The sample size is 654 adult patients (327 per group) undergone thoracic surgery and presenting to the intensive care unit.Ethics and disseminationThis study was approved by the Biomedical Research Ethics Committee of West China Hospital of Sichuan University (REC2019-730). It is expected that this study will lead to a randomised controlled trial. We assume that the findings will provide more evidence about PPCs and improve the management of patients undergone thoracic surgery.Trial registration numberChiCTR2100046356.

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Section: Methods and Analysismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Recruitmentmanoeuvres during mechanical ventilation with sequential high-flow nasal oxygen after extubation to prevent postoperative pulmonary complications in patients undergone thoracic surgery: a protocol, prospective randomised controlled trial

Wang

Xia

et al. 2022

BMJ Open

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“…The data on risk factors and post-operative complications will be obtained from participants' medical charts and from a local research database. Potential predictor variables will include: (1) age, (2) gender, (3) pre-surgical chemo/radiation, (4) tumour staging, (5) tumour type (squamous cell carcinoma/adenocarcinoma), ( 6) surgery type, (7) surgery duration (measured in hours), ( 8) RLN damage, (9) presence/degree of sarcopaenia using the Strength, Assistance With Walking, Rise From a Chair, Climb Stairs, and Falls, 50 (10) malnutrition (weight, body mass index (BMI), >10% wt loss and malnutrition screening tool, 51 (11) oral health assessment tool and ( 12) number of co-morbidities.…”

Section: Risk Factorsmentioning

confidence: 99%

“…2 Surgery for oesophageal cancer is major, with up to 5% risk of mortality and over 50% risk of morbidity, irrespective of whether surgery is via open, minimally invasive or roboticassisted approaches. [3][4][5][6][7] Post-operative complications include pulmonary dysfunction, atrial fibrillation and anastomotic leak. 8 Postoperative pulmonary complications (PPCs) are among the most serious postoperative challenges occurring between 15% and 40%…”

Section: Introductionmentioning

confidence: 99%

Prevalence, nature and trajectory of dysphagia postoesophageal cancer surgery: a prospective longitudinal study protocol

et al. 2022

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IntroductionDysphagia is a common problem following oesophagectomy, and is associated with aspiration pneumonia, malnutrition, weight loss, prolonged enteral feeding tube dependence, in addition to an extended in-hospital stay and compromised quality of life (QOL). To date, the prevalence, nature and trajectory of post-oesophagectomy dysphagia has not been systematically studied in a prospective longitudinal design. The study aims (1) to evaluate the prevalence, nature and trajectory of dysphagia for participants undergoing an oesophagectomy as part of curative treatment, (2) to determine the risk factors for, and post-operative complications of dysphagia in this population and (3) to examine the impact of oropharyngeal dysphagia on health-related QOL across time points.Methods and analysisA videofluoroscopy will be completed and analysed on both post-operative day (POD) 4 or 5 and at 6-months post-surgery. Other swallow evaluations will be completed preoperatively, POD 4 or 5, 1-month and 6-month time points will include a swallowing screening test, tongue pressure measurement, cough reflex testing and an oral hygiene evaluation. Nutritional measurements will include the Functional Oral Intake Scale to measure feeding tube reliance, Malnutrition Screening Tool and the Strength, Assistance With Walking, Rise From a Chair, Climb Stairs and Falls questionnaire. The Reflux Symptom Index will be administered to investigate aerodigestive symptoms commonly experienced by adults post-oesophagectomy. Swallowing-related QOL outcome measures will be determined using the European Organisation for Research and Treatment of Cancer QLQ-18, MD Anderson Dysphagia Inventory and the Swallowing Quality of Life Questionnaire.Ethics and disseminationEthical approval has been granted by the Tallaght University Hospital/St. James’ Hospital Research Ethics Committee (JREC), Dublin, Ireland (Ref. No. 2021-Jul-310). The study results will be published in peer-reviewed journals and presented at national and international scientific conferences.

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The use of indocyanine green (ICYG) angiography intraoperatively to evaluate gastric conduit perfusion during esophagectomy: does it impact surgical decision-making?

LeBlanc,

Takahashi,

Huston

et al. 2023

Surg Endosc

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Risk factors and therapeutic measures for postoperative complications associated with esophagectomy

Cited by 10 publications

References 97 publications

Recruitmentmanoeuvres during mechanical ventilation with sequential high-flow nasal oxygen after extubation to prevent postoperative pulmonary complications in patients undergone thoracic surgery: a protocol, prospective randomised controlled trial

Recruitmentmanoeuvres during mechanical ventilation with sequential high-flow nasal oxygen after extubation to prevent postoperative pulmonary complications in patients undergone thoracic surgery: a protocol, prospective randomised controlled trial

Prevalence, nature and trajectory of dysphagia postoesophageal cancer surgery: a prospective longitudinal study protocol

The use of indocyanine green (ICYG) angiography intraoperatively to evaluate gastric conduit perfusion during esophagectomy: does it impact surgical decision-making?

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