Evaluation of mechanical ventilation mean duration and its predicting factors during transhiatal esophagectomy in patients with esophageal cancer

Tabatabai, Seyed Abbas. and Hashemi, Seyed Mozafar. and Mohajeri, Gholamreza. and Ahmadinejad, Mojtaba. and Goharian, Vahid. and Kolahdouzan, Mohsen. and Abbasi, Saeid. and Mogharehabed, Neda. and davarpanah Jazi, AmirHossein. and Eidi, Mohammad. (2011) Evaluation of mechanical ventilation mean duration and its predicting factors during transhiatal esophagectomy in patients with esophageal cancer. Journal of Isfahan Medical School, 29 (125).

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Abstract

Background: Esophagenctomy is the principle treatment for esophageal and gastroesophageal junction malignancies. Postoperative respiratory failure and other respiratory problems like athelectasis and severe hypoxia occur frequently after esophageal cancer surgeries. Such patients mostly need ICU care and mechanical ventilation. The aim of present study was to evaluate mean duration of mechanical ventilation and its predictor factors during esophageal resection in middle and distal esophageal cancers. Methods: This cross sectional analytic study performed in Al Zahra hospital, Isfahan on medical records of 70 patients with middle and distal esophageal cancer operated by transhiatal method in Department of Thoracic Surgery. Patient's age, sex, tumor location, duration of mechanical ventilation, duration of operation, spirometry findings (FEV1), weight loss, need for transfusion, and serum albumin level on admission extracted from medical charts. Finally all data were analyzed by SPSS16 using chi-square and t tests. Finding: Patient's mean age was 60.71 ± 11.81 years and 64.3 of them were men. Pathologically, 43 patients (61.4) and 26 patients (37.1) were diagnosed by SCC and adenocarcinoma respectively. Totally frequency of complications were 41.4, and 7.1 of subjects were died within first 30 days. 15 patients (21.4) were mechanically ventilated after surgery with mean duration of 1.34 day. Mean duration of mechanical ventilation showed no association with intraoperative pleural rapture, intraoperative blood transfusion, anastomosis leakage, type of pathology, postoperative anastomotic stricture, and empyema. However mean duration of mechanical ventilation were significantly higher in died patients within 30 days after surgery, reintubated subjects, patients with serum albumin level of less than 3.5 g/dl, and patients with less than 2 liter FEV1. Among quantitative variables, only FEV1 were associated with mean duration of mechanical ventilation. Conclusion: As our data showed hypoalbuminemia (which reflects subsequent malnutrition) and less than 2 liter FEV1 is correlates with prolonged mechanical ventilation (and probably more mortality) it is recommended to improve nutritional condition as well as pulmonary function preoperatively to shortened duration of mechanical ventilation and prohibit mortality rate.

Item Type: Article
Additional Information: cited By
Uncontrolled Keywords: serum albumin, adult; aged; anastomosis leakage; article; artificial ventilation; blood transfusion; chi square test; empyema; esophagus cancer; esophagus resection; female; forced expiratory volume; groups by age and sex; human; major clinical study; male; operation duration; postoperative period; spirometry; surgical mortality; weight reduction
Subjects: WI Digestive System
QZ pathology-Neoplasms
Divisions: Faculty of Medicine > Department of Clinical Sciences > Department of Surgery
Depositing User: zahra bagheri .
Date Deposited: 20 Aug 2017 07:16
Last Modified: 17 Feb 2018 08:53
URI: http://eprints.skums.ac.ir/id/eprint/3294

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