[Complications of surgical resection of esophageal cancer].
Esophageal resection has undergone refinements over recent years, with improved outcomes. However, in-hospital mortality remains above 10% in developed countries and is below 5% in only a select group of hospitals. Morbidity remains high even in high-volume hospitals. We reviewed risk factors in esophageal resection. Pulmonary complications occur mainly in older patients and in those with pulmonary dysfunction, especially %FEV1 or hypoxia. Liver cirrhosis, squamous cell cancer, low patient volume, and cervical anastomoses also increase complication rates. Neoadjuvant chemoradiotherapy, which may be effective in squamous cell tumors, can also increase morbidity. The main cause of morbidity and mortality are pleuropulmonary complications. Also significant are anastomotic leak and esophageal conduit necrosis. A complex procedure such as esophageal resection is better served in specialized teams.
González-González
Juan José
JJ
Servicio de Cirugía General. Instituto Universitario de Oncología. Hospital Universitario Central de Asturias. Oviedo. Asturias. España. jjglezglez@terra.es
Sanz-Alvarez
Lourdes
L
Marqués-Alvarez
Lara
L
Navarrete-Guijosa
Francisco
F
Martínez-Rodríguez
Enrique
E
D000230:Adenocarcinoma / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D000367:Age Factors; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D004724:Endoscopy; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects / Q000401:mortality; D005472:Fluorouracil / Q000627:therapeutic use; D005541:Forced Expiratory Volume; D017052:Hospital Mortality; D006801:Humans; D007431:Intraoperative Complications; D020360:Neoadjuvant Therapy; D017671:Platinum Compounds / Q000627:therapeutic use; D011183:Postoperative Complications; D011379:Prognosis; D013902:Radiography, Thoracic; D011879:Radiotherapy Dosage; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed
D000964:Antimetabolites, Antineoplastic; D017671:Platinum Compounds; D005472:Fluorouracil