Complications of the surgical treatment of esophageal cancer and microbiological analysis of the respiratory tract

• Published in: Biomedical papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia Vol. 164; no. 3; pp. 284 - 291
• Main Authors: Vrba, Radek, Neoral, Cestmir, Vomackova, Katherine, Vrana, David, Melichar, Bohuslav, Lubuska, Lucie, Loveckova, Yvona, Aujesky, Rene
• Format: Journal Article
• Language: English
• Published: Palacký University Olomouc, Faculty of Medicine and Dentistry 01-09-2020
• Subjects: esophageal cancer; morbidity; mortality; preoperative examination; respiratory complications
• ISSN: 1213-8118; 1804-7521
• DOI: 10.5507/bp.2019.040

AIMThe aim of this study was to reduce the severe respiratory complications of esophageal cancer surgery often leading to death. METHODSTwo groups of patients operated on for esophageal cancer were evaluated in this retrospective analysis. The first group was operated between 2006-2011, prior to the implementation of preoperative microbiological examination while the second group had surgery between 2012-2017 after implementation of this examination. RESULTSIn total, 260 patients, 220 males and 40 females underwent esophagectomy. Between 2006-2011, 113 (87.6%) males and 16 (12.4%) females and between 2012-2017, esophagectomy was performed in 107 (81.7%) males and 24 (18.3%) females. In the first cohort, 10 patients died due to respiratory complications. The 30-day mortality was 6.9% and 90-day was 9.3%. In the second cohort, 4 patients died from respiratory complications. The 30-day mortality was 1.5% and 90-day mortality was 3.1%. With regard to the incidence of respiratory complications (P=0.014), these occurred more frequently in patients with sputum collection, however, severe respiratory complications were more often observed in patients without sputum collection. Significantly fewer patients died (P=0.036) in the group with sputum collection. The incidence of respiratory complications was very significantly higher in the patients who died (P<0.0001). CONCLUSIONThe incidence of severe respiratory complications (causing death) may be reduced by identifying clinically silent respiratory tract infections.