Respiratory complications following mini-invasive laparoscopic and thoracoscopic esophagectomy for esophageal cancer. Experience in 215 patients.

Vrba, Radek; Vrána, David; Neoral, C; Melichar, Bohuslav; Aujeský, R; Tesaříková, Jana; Cincibuch, Jan; Zapletalová, Jana; Jínek, T; Stašek, Martin

doi:10.5114/wiitm.2018.77276

Cited by 5 publications

(3 citation statements)

References 23 publications

(24 reference statements)

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“…The results revealed that the incidence of overall complications was 45.2% and the incidence of respiratory complications was 28.3% in the control group. The respiratory complication was lower than that reported by a previous study (40% respiratory complication) [ 21 ]. Furthermore, patients in the control group had a lower incidence of postoperative anastomotic leakage, when compared to the incidence reported by a previous study [ 22 ].…”

Section: Discussioncontrasting

confidence: 70%

Outcomes of early fiberoptic bronchoscopic sputum aspiration and lavage after thoracoscopic and laparoscopic esophageal cancer surgery: a randomized clinical trial

Wang,

Xie,

Yang

et al. 2023

J Cardiothorac Surg

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Background This study aims to investigate the outcomes of patients who received early fiberoptic bronchoscopic sputum aspiration and lavage after thoracoscopic and laparoscopic esophagectomy due to esophageal cancer. Methods A prospective randomized clinical trial was performed between March 2020 and June 2022. Patients who were scheduled for thoracoscopic and laparoscopic esophagectomy due to esophageal cancer were enrolled. Then, these patients were assigned to the control group (traditional postoperative care) and study group (traditional postoperative care with early bronchoscopic sputum aspiration and lavage). The outcomes, which included the length of hospital stay and medical expenses, and postoperative complications, which included pulmonary infection, atelectasis, respiratory dysfunction and anastomotic leakage, were compared between these two groups. Results A total of 106 patients were enrolled for the present study, and 53 patients were assigned for the control and study groups. There were no statistically significant differences in gender, age, and location of the esophageal cancer between the two groups. Furthermore, the length of hospital stay was statistically significantly shorter and the medical expenses were lower during hospitalization in the study group, when compared to the control group (12.3 ± 1.2 vs. 18.8 ± 1.3 days, 5.5 ± 0.9 vs. 7.2 ± 1.2 Chinese Yuan, respectively; all, P < 0.05). Moreover, there were statistically significantly fewer incidences of overall complications in study group, when compared to the control group (20.7% vs.45.2%, P < 0.05). Conclusions For patients with esophageal cancer, early fiberoptic bronchoscopic sputum aspiration and lavage after thoracoscopic and laparoscopic esophagectomy can shorten the length of hospital stay, and lower the medical expense and incidence of postoperative complications.

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Section: Discussioncontrasting

confidence: 70%

Outcomes of early fiberoptic bronchoscopic sputum aspiration and lavage after thoracoscopic and laparoscopic esophageal cancer surgery: a randomized clinical trial

Wang,

Xie,

Yang

et al. 2023

J Cardiothorac Surg

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“…Patients with locally advanced ESCC have a poor prognosis. Previous studies [1,4,39] have reported that a high rate of postoperative complications, especially pulmonary complications, is one of the reasons that lead to poor a prognosis. In our study, we found that patients with postoperative pulmonary complications had worse OS and DFS, which further supports previous ndings.…”

Section: Discussionmentioning

confidence: 99%

Preoperative neutrophil-to-lymphocyte ratio predicts postoperative pulmonary complications in patients with esophageal squamous cell carcinoma receiving preoperative chemoradiotherapy

Wang

et al. 2022

Preprint

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Objectives: Esophagectomy after chemoradiotherapy is associated with an increased risk of surgical complications. The significance of preoperative neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in predicting pulmonary complications after esophagectomy in esophageal squamous cell carcinoma patients receiving preoperative chemoradiotherapy remains unknown. We aimed to investigate the utility of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in predicting the pulmonary complications of esophagectomy after preoperative chemoradiotherapy. Methods: We retrospectively reviewed 111 consecutive patients with stage III esophageal squamous cell carcinoma who received preoperative chemoradiotherapy followed by esophagectomy between January 2009 and December 2017. Laboratory data were collected before the operation and surgical outcomes and complications were recorded. We calculated neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio and correlated them with the clinical parameters, postoperative complications, overall survival, and disease-free survival.Results: Postoperative complications were observed in 75 (68%) patients, including 32 (29%) with pulmonary complications. The neutrophil-to-lymphocyte ratio of ≥3 (P = 0.008), clinical T4 carcinoma (P = 0.007), and advanced stage IIIC (P = 0.012) were significantly associated with pulmonary complications. Pulmonary complication rates were 15% and 38% in patients with neutrophil-to-lymphocyte ratio of <3 and ≥3, respectively. The 3-year overall survival rates were 70% and 34% in patients with neutrophil-to-lymphocyte ratio of <3 and ≥3, respectively (P = 0.0026). The 3-year disease-free survival rates were 57% and 29% in patients with neutrophil-to-lymphocyte ratio of <3 and ≥3, respectively (P = 0.0055). The neutrophil-to-lymphocyte ratio of ≥3 was independently associated with more pulmonary complications, inferior overall survival, and worse disease-free survival.Conclusions: Neutrophil-to-lymphocyte ratio is routinely available in clinical practice and can be used as a predictor for pulmonary complications after esophagectomy in patients with esophageal squamous cell carcinoma receiving preoperative chemoradiotherapy.

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“…Minimally invasive techniques have been preferred over the past decade. Less surgical trauma, fewer respiratory complications, and shorter recovery period are reported in cases of minimally invasive oesophagectomy [ 5 , 6 ]. Hybrid oesophagectomy is also associated with better postoperative outcomes compared to the open approach, especially concerning pulmonary complications.…”

Section: Discussionmentioning

confidence: 99%

Hybrid esophagectomy for oesophageal cancer: long-term results. A single-centre experience.

Hlaváčová¹,

Vrba²,

Neoral³

et al. 2020

Videosurgery and Other Miniinvasive Techniques

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Introduction The authors report long-term outcomes in patients who received neoadjuvant chemoradiotherapy and consequently underwent hybrid oesophagectomy for oesophageal cancer (OC). Aim To evaluate long-term outcomes in patients suffering from OC, who underwent hybrid oesophagectomy. Material and methods Our cohort consisted of patients suffering from OC, who received neoadjuvant chemoradiotherapy. Hybrid esophagectomy was performed 8–10 weeks after oncological treatment. Results Ninety-four patients underwent surgery for OC from 2011 to 2015. Histology revealed adenocarcinoma in 60.6%, squamous cell carcinoma (SCC) in 36.2%, and other type of cancer in 3.2%. Seventy-three (77.7%) patients with advanced stage (T3-4, N0-2, M0) were indicated to receive neoadjuvant chemoradiotherapy (nCRT). Trans-hiatal hybrid oesophagectomy was performed in 83 (88.3%) patients. Transthoracic hybrid oesophagectomy was performed in 11 (11.7%) patients. Histology of the resected specimens of 18 (24.7%) patients did not reveal OC, i.e. pathological complete response (pCR). In our cohort, we proved an association between occurrence of pCR and age as well as disease-free survival (DFS). The patients who presented with pCR were significantly younger – below 60 years of age (p = 0.017). They also showed significantly higher mean DFS (p = 0.004). Conclusions Combined oesophagectomy with neoadjuvant chemoradiotherapy results in a better long-term outcome in patients suffering from oesophageal cancer. In our set of patients who underwent hybrid esophagectomy, satisfactory short-term and especially long-term results of surgical treatment for oesophageal cancer were observed.

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Respiratory complications following mini-invasive laparoscopic and thoracoscopic esophagectomy for esophageal cancer. Experience in 215 patients.

Cited by 5 publications

References 23 publications

Outcomes of early fiberoptic bronchoscopic sputum aspiration and lavage after thoracoscopic and laparoscopic esophageal cancer surgery: a randomized clinical trial

Outcomes of early fiberoptic bronchoscopic sputum aspiration and lavage after thoracoscopic and laparoscopic esophageal cancer surgery: a randomized clinical trial

Preoperative neutrophil-to-lymphocyte ratio predicts postoperative pulmonary complications in patients with esophageal squamous cell carcinoma receiving preoperative chemoradiotherapy

Hybrid esophagectomy for oesophageal cancer: long-term results. A single-centre experience.

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