Risk factors associated with postoperative respiratory failure after esophagectomy for esophageal cancer-Reference-Cited by-同舟云学术

Risk factors associated with postoperative respiratory failure after esophagectomy for esophageal cancer

Published:2023-12-29 Issue: Volume: Page:1068-1078
ISSN:2692-3106
Container-title:Exploration of Medicine
language:
Short-container-title:

Author:

Fang Zhanglan¹,Yang Hao¹^ORCID,Long Yi²,Xu Dongyun³,Su Benyu⁴^ORCID,Xu Chao⁵^ORCID,Yang Huguang¹,Xu Feng⁴^ORCID,Luo Ling¹

Affiliation:

1. Department of Internal Medicine, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing 400030, China

2. Department of Critical Care Medicine, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing 400030, China

3. Department of Anesthesia and Surgery, Shengli Oilfield Central Hospital, Dongying 257034, Shandong, China

4. Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education, Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong, China; Shandong Institute of Endocrine and Metabolic Diseases, Jinan 250021, Shandong, China; Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan 250021, Shandong, China

5. Department of Endocrinology and Metabolism, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong, China; Department of Endocrinology and Metabolism, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250021, Shandong, China; Shandong Provincial Key Laboratory of Endocrinology and Lipid Metabolism, Jinan 250021, Shandong, China

Abstract

Aim: Respiratory failure is common after esophagectomy for esophageal cancer (EC). This study aimed to identify the risk factors associated with postoperative respiratory failure following esophagectomy for EC. Methods: A single-center observational study from China was conducted on 262 patients with EC who underwent thoracoscopic esophagectomy between April 2014 and June 2016. The patients were divided into two groups: group I (respiratory failure) and group II (without respiratory failure). Demographic and perioperative variables, tumor-related factors, surgical factors, Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, and clinical course were compared between the groups. Univariable and multivariable logistic regression analyses were performed to assess the risk factors of postoperative respiratory failure after esophagectomy. Results: Among the 262 patients, 24 (9.2%) developed respiratory failure. Univariable analysis revealed several risk factors, including age, smoking, comorbidities, partial pressure of oxygen (PO2), partial pressure of carbon dioxide (PCO2), forced vital capacity (FVC), FVC percentage (FVC%), urine volume during surgery, and APACHE II score. Multivariable analysis showed that age, comorbidities of diabetes mellitus (DM), FVC%, urine volume during surgery, and APACHE II score were independent predictors of respiratory failure. Specifically, elderly patients (> 65 years) with comorbidities of DM, lower FVC%, higher urine volume during surgery, and elevated APACHE II score were found to be more susceptible to respiratory failure, resulting in prolonged hospitalization and increased healthcare burden. These findings emphasize the importance of considering these factors in the management and care of patients at risk of respiratory failure. Conclusions: As a common complication following esophagectomy for EC. Respiratory failure is significantly associated with age, comorbidities of DM, FVC%, urine volume during surgery, and APACHE II score in the dataset. The findings will contribute to the evaluation of the risk of respiratory failure and guide early intervention strategies in clinical decision-making.

Publisher

Open Exploration Publishing

Subject

Molecular Medicine

Reference44 articles.

1. Matz M, Valkov M, Šekerija M, Luttman S, Caldarella A, Coleman MP, et al. Worldwide trends in esophageal cancer survival, by sub-site, morphology, and sex: an analysis of 696,974 adults diagnosed in 60 countries during 2000-2014 (CONCORD-3). Cancer Commun (Lond). 2023;43:963–80.

2. Abou Chaar MK, Godin A, Harmsen WS, Wzientek C, Saddoughi SA, Hallemeier CL, et al. Determinants of long-term survival decades after esophagectomy for esophageal cancer. Ann Thorac Surg. 2023;116:1036–44.

3. Gu YM, Zhang HL, Yang YS, Yuan Y, Hu Y, Che GW, et al. Short- and long-term outcomes of totally versus hybrid minimally invasive Ivor Lewis oesophagectomy for oesophageal cancer: a propensity score-matched analysis. Front Oncol. 2022;12:849250.

4. Zhang Y, Dong D, Cao Y, Huang M, Li J, Zhang J, et al. Robotic versus conventional minimally invasive esophagectomy for esophageal cancer: a meta-analysis. Ann Surg. 2023;278:39–50.

5. Atkins BZ, Shah AS, Hutcheson KA, Mangum JH, Pappas TN, Harpole DH Jr, et al. Reducing hospital morbidity and mortality following esophagectomy. Ann Thorac Surg. 2004;78:1170–6.