[A clinical study on respiratory management using a respirator with nasal intubation in patients undergoing surgery for esophageal cancer].
We analyzed a postoperative respiratory management using a respirator with nasal intubation in 55 patients who underwent subtotal esophagectomy through thoracic and abdominal approach between April 1984 and December 1989. In 21 cases (38%) the period using a respirator was within 3 days, in 24 cases (44%) during 4-7 days, and in 10 cases (18%) over 8 days. Postoperative pulmonary complications occurred in 20 cases (36%); pneumonia in 7 cases (13%), lung edema in 12 cases (22%), atelectasis in one case (2%). Two patient died after surgery, one from acute myocardial infarction, another from multiple organ failure after anastomotic leakage. The period using a respirator was positively correlated with the operative blood loss, transfusion and post-operative infusion, postoperative pulmonary complications positively correlated with the operative time, the anesthetic time, operative blood loss, transfusion and postoperative infusion as well as with preoperative complications and renal dysfunction too. In 120 cases before 1984, postoperative pneumonia occurred in 42 cases (36) and 19 cases (16%) of them died. These results suggest that our respiratory management using a respirator is effective in perioperative period of esophageal cancer.
Yoneyama
K
K
Department of Surgery (I), Yokohama City University School of Medicine, Japan.
Aoyama
N
N
Akaike
M
M
Tokunaga
M
M
Minamide
J
J
Yamamoto
Y
Y
Imada
T
T
Amano
T
T
Matsumoto
A
A
D000368:Aged; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy; D005260:Female; D006801:Humans; D007440:Intubation / Q000379:methods; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D012121:Respiration, Artificial; D012122:Ventilators, Mechanical