Strategies to decrease morbidity in surgical management of esophageal cancer: a single center experience.
Journal
Minerva surgery
ISSN: 2724-5438
Titre abrégé: Minerva Surg
Pays: Italy
ID NLM: 101777295
Informations de publication
Date de publication:
Apr 2023
Apr 2023
Historique:
medline:
7
4
2023
pubmed:
17
6
2022
entrez:
16
6
2022
Statut:
ppublish
Résumé
In this study we described our experience in decreasing morbidity by performing a few changes during and after the Ivor Lewis esophagectomy. This is a retrospective single center experience comparing a control period (group A) and a study period (group B) in patients who underwent esophagectomy for esophageal cancer (control group: 23; study group: 17). Control group had postero-lateral thoracotomy and a gastric tube without aspiration during postoperative period. Study group had limited lateral muscle sparing thoracotomy and postoperatively the gastric tube was routinely left for 1 week with intermittent aspiration (10 times every two hours for 1 week). Average operation time was 312±56 minutes in control period, in study period 189±36 min. Average ICU stay was 10 (7-32) days in the control group, in study group 4 (1-8) days. Anastomotic leak rate was significantly higher in control vs. study group (53.3% vs. 16.6%; P<0.05). Respiratory complications were significantly lower in the study group (47.8% vs. 17.6%). The combination of a limited lateral thoracotomy and postoperative intermittent aspiration seem to reduce the rate of respiratory and anastomotic complication after Ivor-Lewis' procedure.
Sections du résumé
BACKGROUND
BACKGROUND
In this study we described our experience in decreasing morbidity by performing a few changes during and after the Ivor Lewis esophagectomy.
METHODS
METHODS
This is a retrospective single center experience comparing a control period (group A) and a study period (group B) in patients who underwent esophagectomy for esophageal cancer (control group: 23; study group: 17). Control group had postero-lateral thoracotomy and a gastric tube without aspiration during postoperative period. Study group had limited lateral muscle sparing thoracotomy and postoperatively the gastric tube was routinely left for 1 week with intermittent aspiration (10 times every two hours for 1 week).
RESULTS
RESULTS
Average operation time was 312±56 minutes in control period, in study period 189±36 min. Average ICU stay was 10 (7-32) days in the control group, in study group 4 (1-8) days. Anastomotic leak rate was significantly higher in control vs. study group (53.3% vs. 16.6%; P<0.05). Respiratory complications were significantly lower in the study group (47.8% vs. 17.6%).
CONCLUSIONS
CONCLUSIONS
The combination of a limited lateral thoracotomy and postoperative intermittent aspiration seem to reduce the rate of respiratory and anastomotic complication after Ivor-Lewis' procedure.
Identifiants
pubmed: 35708447
pii: S2724-5691.22.09627-7
doi: 10.23736/S2724-5691.22.09627-7
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM