[Postoperative respiratory management in patients undergoing radical surgery with three fields lymph node dissection for thoracic esophageal cancer: clinical benefits of assisted ventilation with mini-tracheostomy].
The benefits of early extubation and assisted ventilation with mini-tracheostomy and preventive positive pressure ventilation in the early stage after thoracic esophageal cancer operation are examined and compared. Subjects were 23 patients who underwent radical operation for thoracic esophageal cancer in our hospital over a 5 year period. Ten patients (A group) underwent positive pressure ventilation with postoperative intubation for a certain period. Thirteen patients (B group) were extubated the day after operation, then immediately mini-tracheostomized, and then intermittent high-frequency jet ventilation during the daytime and pressure controlled ventilation during the nighttime were conducted. There were no differences in background factors between the two groups. The mean period of tracheal intubation was 8.8 days in the A group and 1.6 days in the B group. The mean period of stay in ICU was 13 days in the A group and 7 days in the B group. Both such periods were significantly shorter in the B group than in the A group. Respiratory control by early extubation and mini-tracheostomy after thoracic esophageal cancer operation is considered to have the following two benefits; 1. The method is performed safely, and makes sputum suction easier and assisted respiration conductible. 2. The method reduces the incidence of pulmonary complications and shortens the period of stay in ICU.
Kido
T
T
Department of Surgery, Osaka Prefectural General Hospital, Japan.
Tanaka
Y
Y
Hazama
K
K
Inoue
Y
Y
Honda
M
M
Yamamoto
S
S
Aono
T
T
Matsuo
Y
Y
Watanabe
H
H
Takao
T
T
Uchiyama
A
A
Mori
T
T
D000368:Aged; D004938:Esophageal Neoplasms / Q000601:surgery* / Q000628:therapy; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D011175:Positive-Pressure Respiration; D011182:Postoperative Care / Q000379:methods*; D012121:Respiration, Artificial; D014139:Tracheostomy