title: Risk factors for postoperative respiratory complications following esophageal cancer resection.
abstract: The development of surgical and postoperative management techniques has improved the treatment outcomes of esophageal cancer resection. However, respiratory morbidity is still the most frequent complication after esophagectomy. The objective of the present study was to identify risk factors for respiratory complications following resection for esophageal cancer. This study included 96 patients with esophageal cancer who had undergone esophagectomy with lymph node dissection. The patients were divided into 2 groups according to the presence (20 patients, 17 had pneumonia and 3 had acute respiratory distress syndrome) or absence (76 patients) of postoperative respiratory complications (PRC). The two groups were compared with respect to their preoperative clinical variables, such as age, body mass index, smoking history, serum albumin, serum C-reactive protein (CRP), number of lymphocytes, %VC, FEV1.0% and FEV1.0. Furthermore, multiple logistic regression analyses were used to estimate relative risk factors for respiratory complications. Results of the univariate analysis showed that smoking history (+/-, patients with PRC, 19/1 and without PRC, 53/23), serum CRP (≥1.0 mg/dl/<1.0 mg/dl, patients with PRC, 6/14 and without PRC, 6/70) and FEV1.0% (≥60%/<60%, patients with PRC, 16/4 and without PRC, 73/3) were significantly different between the two groups. Multiple logistic regression analysis showed that FEV1.0% was the strongest predictor of PRC. FEV1.0%, serum CRP and smoking history are reliable predictors of the risk of respiratory complications following esophageal cancer resection. For patients with these factors, perioperative management for the prevention of postoperative respiratory complications should be considered.
authors: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto 602-8566, Japan.
authors: Atsushi
authors: A
authors: Shiozaki
authors: Hitoshi
authors: H
authors: Fujiwara
authors: Hiroko
authors: H
authors: Okamura
authors: Yasutoshi
authors: Y
authors: Murayama
authors: Shuhei
authors: S
authors: Komatsu
authors: Yoshiaki
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authors: Kuriu
authors: Hisashi
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authors: Ikoma
authors: Masayoshi
authors: M
authors: Nakanishi
authors: Daisuke
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authors: Ichikawa
authors: Kazuma
authors: K
authors: Okamoto
authors: Toshiya
authors: T
authors: Ochiai
authors: Yukihito
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authors: Kokuba
authors: Eigo
authors: E
authors: Otsuji