Clinical usefulness of a perioperative bacteriological culture to treat patients with postoperative pneumonia after esophagectomy

Matsunaga, Tomoyuki; Miyata, Hiroshi; Sugimura, Keijiro; Asukai, Kei; Yanagimoto, Yoshitomo; Takahashi, Yusuke; Tomokuni, Akira; Yamamoto, Keiji; Akita, Hirofumi; Nishimura, Junichi; Wada, Hiroshi; Takahashi, Hidenori; Yasui, Masayoshi; Omori, Takeshi; Oue, Masayuki; Yano, Masahiko

doi:10.1002/ags3.12210

Cited by 4 publications

(8 citation statements)

References 31 publications

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“…Because P.aeruginosa affected immunosuppressed patients, careful management would be essential for CD patients under treatment. 31 , 32 The current findings suggest that organisms at the site of SSI were resistant to the prophylactic antibiotic cefmetazole and that most of the antibiotic sensitivity results were the same between drainage fluid and of SSI bacterial culture. This suggested that sensitivity results in drainage fluid could guide the choice of an antibiotic.…”

Section: Discussionmentioning

confidence: 60%

“…Our data also showed that E. faecalis and P. aeruginosa were significantly detected in CD patients with organ/space SSI. Because P.aeruginosa affected immunosuppressed patients, careful management would be essential for CD patients under treatment 31,32 . The current findings suggest that organisms at the site of SSI were resistant to the prophylactic antibiotic cefmetazole and that most of the antibiotic sensitivity results were the same between drainage fluid and of SSI bacterial culture.…”

Section: Discussionmentioning

confidence: 68%

Section: Ta B L E 3 (Continued)mentioning

confidence: 68%

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Usefulness of Bacterial Culture of Drainage Fluid for Predicting Surgical Site Infection After Crohn’s Disease Surgery

Ichihara

Ogino

Fujii

et al. 2021

Annals of Gastroent Surgery

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Crohn's disease (CD) involves chronic intestinal inflammation and differences in gut bacterial species compared with healthy controls. 1,2 Despite improvements in medical treatments, 70%-90% of patients will undergo surgery in their lifetime. 3 More than half of them will require surgical intervention within 15 y of previous operations because of recurrence or new lesions occurrence. [4][5][6] Postoperative

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Section: Discussionmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 68%

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Usefulness of Bacterial Culture of Drainage Fluid for Predicting Surgical Site Infection After Crohn’s Disease Surgery

Ichihara

Ogino

Fujii

et al. 2021

Annals of Gastroent Surgery

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“…Previous studies report conflicting results about the relationship between the presence of pathogenic bacteria detected in perioperative routine cultures and postoperative pneumonia 8,14,16) 8,14) . On the other hand, Matsui et al showed that detection of bacterial species by sputum culture on the first postoperative day was an independent risk factor of postoperative pneumonia 17) , although, this study did not focus on severity of pneumonia.…”

Section: Discussionmentioning

confidence: 99%

“…It is generally considered that aspiration of oropharyngeal pathogens is one of the main causes of postoperative pneumonia 8,9) . Several studies identified pathogens in the oral cavity, dental plaque, and tracheal sputum as risk factors for respiratory infections after esophagectomy 10,11) .…”

Section: Introductionmentioning

confidence: 99%

Preoperative bacterial culture can predict severe pneumonia in patients receiving esophagectomy

Kaneta

Sato

Nakano

et al. 2022

FJMS

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Background : Postoperative pneumonia is one of the major complications after esophagectomy. The aim of this study was to determine whether bacterial cultures before esophagectomy could predict occurrence of postoperative pneumonia and help treatment strategies for postoperative pneumonia. Methods : Sixtynine patients who underwent subtotal esophagectomy at Fukushima Medical University Hospital between January 2017 and May 2021 were included in this study. We collected sputum, oral, and/or nasopharyngeal swabs for bacterial culture preoperatively from all patients and from those who were suspected of postoperative pulmonary infections. We compared cultured pathogenic bacteria obtained preoperatively and postoperatively from patients who developed postoperative pneumonia, and investigated their association with incidence of postoperative pneumonia. Results : Postoperative pneumonia occurred in 22 of 69 patients (31%), including 13 cases of severe pneumonia with a Clavien -Dindo classification of grade IIIa or higher. Multivariate analysis revealed that longer operative duration (for 30 minutes increase ; odds ratio 1.27, 95% CI 1.01 -1.51, p=0.039) and positivity for preoperative bacterial culture (odds ratio 5.03, 95% CI 1.31 -19.2, p=0.018) were independent risk factors for severe postoperative pneumonia, but not for all incidences of postoperative pneumonia. Of note, in only 5 of the 22 patients with pneumonia, the same pathogenic species were detected preoperatively and after the onset of pneumonia. Conclusions : Our results imply that preoperative bacterial culture may be useful to predict severe postoperative pneumonia. However, it may not be useful in determining pathogenic bacteria responsible for postoperative pneumonia.

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Risk factors and long‐term postoperative outcomes in patients with postoperative dysphagia after esophagectomy for esophageal cancer

Sugase

Miyata

Sugimura

et al. 2022

Annals of Gastroent Surgery

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Aim: Dysphagia is one of the most common complications after esophagectomy.However, no study has investigated the long-term postoperative outcomes in patients with postoperative dysphagia. Here, we aimed to identify risk factors for postoperative dysphagia and to investigate long-term postoperative outcomes in such patients.Methods: This study included 304 consecutive patients with thoracic esophageal cancer who underwent curative esophagectomy. They were diagnosed with postoperative dysphagia through a contrast videofluoroscopic swallowing study, and postoperative outcomes were compared based on swallowing function. Results:In total, 112 patients (37%) were diagnosed with postoperative dysphagia.Older age, low BMI, and recurrent laryngeal nerve palsy were identified as independent risk factors for postoperative dysphagia. In the dysphagia group, a significantly larger number of patients developed in-hospital pneumonia, and hospital stays were also significantly extended. After discharge, 37 (33%) patients with postoperative dysphagia developed pneumonia. Even more than 1 year after esophagectomy, a significantly larger number of patients (24 patients, 21%) with postoperative dysphagia developed pneumonia compared to those without postoperative dysphagia.Postoperative dysphagia was identified as an independent risk factor for out-ofhospital pneumonia. Regarding nutritional status, there was no difference in weight loss 1 year after esophagectomy, but significant weight loss was observed 2 years after esophagectomy in the dysphagia group. Conclusion:Postoperative dysphagia was associated with both preoperative patient factors and surgical factors. Moreover, patients with postoperative dysphagia had long-term and short-term pneumonia risk. The personalization of long-term follow-up through more aggressive rehabilitation and nutritional guidance is required for patients with postoperative dysphagia.

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Clinical usefulness of a perioperative bacteriological culture to treat patients with postoperative pneumonia after esophagectomy

Cited by 4 publications

References 31 publications

Usefulness of Bacterial Culture of Drainage Fluid for Predicting Surgical Site Infection After Crohn’s Disease Surgery

Usefulness of Bacterial Culture of Drainage Fluid for Predicting Surgical Site Infection After Crohn’s Disease Surgery

Preoperative bacterial culture can predict severe pneumonia in patients receiving esophagectomy

Risk factors and long‐term postoperative outcomes in patients with postoperative dysphagia after esophagectomy for esophageal cancer

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