Intraoperative hypotension is not associated with adverse short-term postoperative outcomes after esophagectomy in esophageal cancer patients

Abstract

Background The effect of low systolic blood pressure and its subsequent postoperative outcome during esophagectomy for esophageal cancer is not well studied. Methods A prospective study was conducted and data were collected on patients who underwent esophagectomy and esophagogastric anastomosis for esophageal cancer. Intraoperative hypotension (IOH), defined as systolic blood pressure (SBP) < 90 mm Hg lasting more than 5 min, was recorded. Patients’ 30 days post-operative composite outcome of mortality, anastomotic leak, and prolonged hospital stay were analyzed as outcome variables. Result A total of 54 patients underwent esophagectomy for esophageal cancer during the study period. The mean age was 54 years. The mean duration of the surgery was 208 min. Intraoperative mean low SBP was 80 mmHg while the lowest record was 55 mmHg. IOH occurred in 51% (n = 29) of patients. Anastomotic leak occurred in 7% (n = 4) (OR 1.2, 95% CI 0.26–6.3; p = 0.76). In-hospital mortality was 5% (n = 3) (OR 1.44, 95% CI 0.22–9.3; p = 0.7) and 33% (n = 18) had prolonged hospital stay (OR 0.53, 95% CI 0.14–1.9; p = 0.34). The overall anastomotic leak rate was 13% (n = 7). Multivariate analysis (logistic regression model) showed SBP < 90 mmHg for more than 5 min was not significantly associated either with individual or composite outcomes of mortality, anastomotic leak, and prolonged hospital stay (AOR 1.06, 95% CI 0.98–1.14; p = 0.16) Conclusion In patients undergoing esophagectomy for esophageal cancer, a systolic blood pressure < 90 mm Hg for greater than 5 min during surgery has no significant statistical association with composite adverse outcomes of mortality, anastomotic leak, and prolonged hospital stay.

The Expression of Circulating miR-497 and Metadherin in Hepatocellular Carcinoma: Relation to the Tumor Characteristics and Patients’ Survival

“…Zhu et al [ 44 ] reported that the clinical outcome was consistently poorer for the high metadherin expression group than for the low metadherin expression group in the cumulative recurrence rates and in the overall survival rates. Recent studies have shown that miR-497 is upregulated in several other types of cancer [ 4 ]. Lan et al [ 45 ] discovered that miR-497 over-expression protects tumor cells from apoptosis and enhances resistance to temozolomide in glioma.…”

“…Regardless of the advancement of HCC diagnostic and therapeutic tools, the patients’ prognosis is still poor due to increased metastasis and recurrence rates. There is an essential need to discover new diagnostic and prognostic markers for better prediction of disease outcomes and improvement of patients’ survival [ 4 ].…”

Open removal of pediatric airway foreign body: A case report and literature review

“…For example, age, sex, and Tracheobronchial anatomy are intrinsic factors influencing this field. External factors such as residence, FB species, and prehospital time can be mentioned [ 6 ]. Cultural contexts and eating habits in specific geographic areas play a significant role [ 5 ].…”

Physician-Related Variability in the Outcomes of an Invasive Treatment for Neck and Back Pain: A Multi-Level Analysis of Data Gathered in Routine Clinical Practice

“…Most reports on learning curves or variability across practitioners for invasive treatments for neck or low back pain focus on interventions other than NRT, many of which lack high quality evidence supporting their efficacy and effectiveness. Moreover, they are based on small samples (e.g., ≤150 patients or ≤3 practitioners), do not use multi-level analyses to adjust results for patient prognosis as established by previously validated models, or have been conducted either retrospectively or outside routine practice conditions (e.g., based on data gathered in randomized controlled trials) [ 8 , 9 , 10 , 11 , 12 , 13 , 40 , 41 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 ]. Therefore, it is inappropriate to compare such data with results from this study.…”