Pre-operative dental brushing can reduce the risk of postoperative pneumonia in esophageal cancer patients.
BACKGROUND
The presence of pathogens in dental plaque is a risk factor associated with postoperative pneumonia in esophageal cancer patients. The effectiveness of pre-operative dental brushing to decrease the risk of postoperative pneumonia in esophageal cancer patients was evaluated prospectively.


METHODS
A total of 86 thoracic esophageal cancer patients who underwent an esophagectomy were investigated. Patients were divided into 2 groups: the control group (41 patients) and the pre-operative dental brushing group (45 patients). The patients in the brushing group were assigned to brush their teeth 5 times a day. After the operation, the frequency of postoperative pneumonia and need for tracheostomy for pulmonary treatment was calculated.


RESULTS
Postoperative pneumonia was decreased markedly from 32% to 9% (P = .013), and the frequency of postoperative pneumonia requiring tracheostomy decreased from 12% to 0% in the dental brushing group, respectively. Limiting the patients who had positive pathogenic bacteria in their dental plaque on their admission, the frequency of postoperative pneumonia was decreased from 71% (5 of 7 patients) in the control group to 17% (2 of 12 patients) in the dental brushing group (P = .045).


CONCLUSIONS
Frequent pre-operative dental brushing is performed easily and seems to prevent postoperative pneumonia in esophageal cancer patients.
Akutsu
Yasunori
Y
Department of Frontier Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan. yakutsu@faculty.chiba-u.jp
Matsubara
Hisahiro
H
Shuto
Kiyohiko
K
Shiratori
Toru
T
Uesato
Masaya
M
Miyazawa
Yukimasa
Y
Hoshino
Isamu
I
Murakami
Kentaro
K
Usui
Akihiro
A
Kano
Masayuki
M
Miyauchi
Hideaki
H
D019072:Antibiotic Prophylaxis; D001419:Bacteria / Q000302:isolation & purification / Q000472:pathogenicity; D001424:Bacterial Infections / Q000517:prevention & control; D003773:Dental Plaque / Q000150:complications / Q000382:microbiology / Q000517:prevention & control*; D004938:Esophageal Neoplasms / Q000601:surgery*; D006801:Humans; D011014:Pneumonia / Q000453:epidemiology / Q000517:prevention & control*; D011183:Postoperative Complications / Q000517:prevention & control*; D011300:Preoperative Care; D012307:Risk Factors; D013899:Thoracic Neoplasms / Q000601:surgery*; D014099:Toothbrushing / Q000379:methods*