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PATIENTS WITH PULMONARY COMPLICATIONS AFTER ESOPHAGECTOMY AND TREATMENT APPROACHES

Year 2019, Issue: 2, 333 - 338, 01.06.2019

Mehmet Erdem Çakmak Hayriye Cankar Dal Derya Ademoğlu Serdar Yamanyar Büşra Tezcan Dilek Kazancı Ayşegül Özgök Sema Turan

Abstract

Subtotal esophagectomy involves esophagectomy and esophagogastric anastomosis with thoracotomy after gastric release emptying . It can be performed to remove esophageal carcinomas, high - grade dysplasia, and caustic esophageal injuries. Atelectasis, pneumonia, aspiration and prolonged respiratory failure may occur as pulmonary complications in the postoperative period. The rate of pulmonary complications ranges from 20% to 50%. The development of pulmonary complications not only prolongs the hospital stay but it also increases the mortality and morbidity significantly. In this study, we retrospectively evaluated 5 cases with postoperative pulmonary complications. Postoperatively, 4 cases had pneumonia, 1 had atelectasis, 1 had a pneumothorax and subcutaneous emphysema. One patient died in the postoperative period due to anastomotic leakage. Pulmonary complication rates can be reduced with careful preoperative evaluation and appropriate postoperative measures. In this study, we aimed to evaluate the postoperative pulmonary complications after esophageal surgery

Keywords

Esophagectomy lung complications

References

  • Wu J, Chai Y, Zhou XM, et al. Ivor Lewis subtotal esophagectomy with two-field lymphadenectomy for squamous cell carcinoma of the lower thoracic esophagus. World J Gastroenterol 2008;14:5084- 9. [CrossRef]
  • Allen MS. Transthoracic resection of the esophagus. In Shields TW, LoCicero J, Reed CE, ed. General ThoracicSurgery, vol 2, 7th ed. Philadelphia: Lippincott Williams and Wilkins; 2009:1752-9.
  • Nafteux P, Coosemans W, De Leyn P, et al. Ivor Lewis esophagectomy. In: Sugarbaker D, Bueno R, Krasna MJ, ed. Adult Chest Surgery, 1st ed. New York City: McGraw- Hill; 2009:155-62.
  • Günlüoğlu MZ. Postoperatif Pulmoner Komplikasyonlar. Yücel O, Genç O, editörler. Journal of Clinical and Analytical Medicine Kitap Serisi, Akciğer Hastalıkları ve Tedavisi 2013; [CrossRef]
  • Ferguson MK, Durkin AE. Preoperative prediction of the risk of pulmonary complications after esophagectomy for cancer. J Thorac Cardiovasc Surg 2002;123:661-9.
  • Celli BR, Rodriguez KS, Snider GL. A controlled trial of intermittent positive pressure breathing, incentive spirometry, and deep breathing exercises in preventing pulmonary complications after abdominal surgery. Ann Rev Respir Dis 1984;130:12-5. [CrossRef]
  • Roukema JA, Carol EJ, Prins JG. The prevention of pulmonary complications after upper abdominal surgery in patients with noncompromised pulmonary status. Arch Surg 1988;123:30-4.
  • Fagevik Olsen M, Hahn I, Nordgren S, Lönroth H, Lundholm K. Randomized controlled trial of prophylactic chest physiotherapy in major abdominal surgery. Br J Surg 1997;84:1535-8.
  • Warner MA, Offord KP, Warner ME, Lennon RL, Conover MA, Jansson- Schumacher U. Role of preoperative cessation of smoking and other risk factors in postoperative pulmonary complications: A blinded prospective study of coronary artery bypass. Mayo Clin Proc 1989;64:609-16.
  • Buist AS, Sexton GJ, Nagy JM, Ross BB. The effect of smoking cessation and modification of lung function. Am Rev Respir Dis 1976;114:115-22. [CrossRef]
  • Detsky AS, Baker JP, O’Rouke K, Goel V. Perioperative parenteral nutrition: a meta-analysis. Ann Intern Med 1987;107:195-203.
  • Moore FA, Feliciano DV, Andrassy RJ, et al. Early enteral feeding, compared with parenteral, reduces postoperative septic complications. The results of a meta-analysis. Ann Surg 1992;216:172-83.
  • Edwards MR, Grocott MPW. Perioperative Fluid and Electrolyte Therapy. Miller 8th edition, Chapter 59, Sayfa 1767-1808. 2015
  • Lewis KS, Whipple JK, Michael KA, Quebbeman EJ. Effect of analgesic treatment on the physiological consequences of acute pain. Am J Hosp Pharm 1994;51:1539-54.
  • Avendano CE, Patrick AF, Silvestri GA. Pulmonary complications after esophagectomy. Ann Thorac Surg 2002;73:922-6.
  • Shiozaki A, Fujiwara H, Okamura H, et al. Risk factors for postoperative respiratory complications following esophageal cancer resection. Oncol Lett 2012;3:907-12. [CrossRef]

Özofajektomi Sonrası Pulmoner Komplikasyon Gelişen Olgular ve Tedavi Yaklaşımları

Year 2019, Issue: 2, 333 - 338, 01.06.2019

Mehmet Erdem Çakmak Hayriye Cankar Dal Derya Ademoğlu Serdar Yamanyar Büşra Tezcan Dilek Kazancı Ayşegül Özgök Sema Turan

Abstract

Subtotal özofajektomi mide serbestleştirilmesi sonrası torakotomi ile özofajektomi ve özofagogastrik anastomozu içerir. Özofagus karsinomunda, yüksek dereceli displazide, kostik özofageal yaralanmalarda uygulanabilir. Bu operasyon sonrası atelektazi, pnömoni, aspirasyon ve uzamış entübasyon gerektiren solunum yetmezliği pulmoner komplikasyon olarak görülebilir. Pulmoner komplikasyonların oranı %20 ile %50 arasında değişmektedir. Pulmoner komplikasyon gelişimi hastanede kalış süresini uzatmanın yanı sıra mortalite ve morbiditeyi anlamlı oranda arttırmaktadır. Bu çalışmada postoperatif pulmoner komplikasyon gelişen 5 olguyu retrospektif olarak değerlendirdik. Olguların postoperatif dönemde 4 tanesinde pnömoni, 1’inde atelektazi, 1’inde pnömotoraks ve cilt altı amfizem geliştiği saptandı. Bir hasta postoperatif dönemde anastomoz kaçağına bağlı exitus oldu. Dikkatli bir preoperatif değerlendirme ve uygun postoperatif önlemler ile pulmoner komplikasyon oranları azaltılabilir. Bu çalışmada özofagus cerrahisi sonrası postoperatif pulmoner komplikasyon gelişen olguları değerlendirmeyi amaçladık

Keywords

Özofajektomi akciğer komplikasyonlar

References

  • Wu J, Chai Y, Zhou XM, et al. Ivor Lewis subtotal esophagectomy with two-field lymphadenectomy for squamous cell carcinoma of the lower thoracic esophagus. World J Gastroenterol 2008;14:5084- 9. [CrossRef]
  • Allen MS. Transthoracic resection of the esophagus. In Shields TW, LoCicero J, Reed CE, ed. General ThoracicSurgery, vol 2, 7th ed. Philadelphia: Lippincott Williams and Wilkins; 2009:1752-9.
  • Nafteux P, Coosemans W, De Leyn P, et al. Ivor Lewis esophagectomy. In: Sugarbaker D, Bueno R, Krasna MJ, ed. Adult Chest Surgery, 1st ed. New York City: McGraw- Hill; 2009:155-62.
  • Günlüoğlu MZ. Postoperatif Pulmoner Komplikasyonlar. Yücel O, Genç O, editörler. Journal of Clinical and Analytical Medicine Kitap Serisi, Akciğer Hastalıkları ve Tedavisi 2013; [CrossRef]
  • Ferguson MK, Durkin AE. Preoperative prediction of the risk of pulmonary complications after esophagectomy for cancer. J Thorac Cardiovasc Surg 2002;123:661-9.
  • Celli BR, Rodriguez KS, Snider GL. A controlled trial of intermittent positive pressure breathing, incentive spirometry, and deep breathing exercises in preventing pulmonary complications after abdominal surgery. Ann Rev Respir Dis 1984;130:12-5. [CrossRef]
  • Roukema JA, Carol EJ, Prins JG. The prevention of pulmonary complications after upper abdominal surgery in patients with noncompromised pulmonary status. Arch Surg 1988;123:30-4.
  • Fagevik Olsen M, Hahn I, Nordgren S, Lönroth H, Lundholm K. Randomized controlled trial of prophylactic chest physiotherapy in major abdominal surgery. Br J Surg 1997;84:1535-8.
  • Warner MA, Offord KP, Warner ME, Lennon RL, Conover MA, Jansson- Schumacher U. Role of preoperative cessation of smoking and other risk factors in postoperative pulmonary complications: A blinded prospective study of coronary artery bypass. Mayo Clin Proc 1989;64:609-16.
  • Buist AS, Sexton GJ, Nagy JM, Ross BB. The effect of smoking cessation and modification of lung function. Am Rev Respir Dis 1976;114:115-22. [CrossRef]
  • Detsky AS, Baker JP, O’Rouke K, Goel V. Perioperative parenteral nutrition: a meta-analysis. Ann Intern Med 1987;107:195-203.
  • Moore FA, Feliciano DV, Andrassy RJ, et al. Early enteral feeding, compared with parenteral, reduces postoperative septic complications. The results of a meta-analysis. Ann Surg 1992;216:172-83.
  • Edwards MR, Grocott MPW. Perioperative Fluid and Electrolyte Therapy. Miller 8th edition, Chapter 59, Sayfa 1767-1808. 2015
  • Lewis KS, Whipple JK, Michael KA, Quebbeman EJ. Effect of analgesic treatment on the physiological consequences of acute pain. Am J Hosp Pharm 1994;51:1539-54.
  • Avendano CE, Patrick AF, Silvestri GA. Pulmonary complications after esophagectomy. Ann Thorac Surg 2002;73:922-6.
  • Shiozaki A, Fujiwara H, Okamura H, et al. Risk factors for postoperative respiratory complications following esophageal cancer resection. Oncol Lett 2012;3:907-12. [CrossRef]
There are 16 citations in total.

Details

Primary Language Turkish
Journal Section Case Report
Authors

Mehmet Erdem Çakmak

Hayriye Cankar Dal

Derya Ademoğlu

Serdar Yamanyar

Büşra Tezcan

Dilek Kazancı

Ayşegül Özgök

Sema Turan

Publication Date June 1, 2019
Published in Issue Year 2019Issue: 2

Cite

EndNote Çakmak ME, Dal HC, Ademoğlu D, Yamanyar S, Tezcan B, Kazancı D, Özgök A, Turan S (June 1, 2019) Özofajektomi Sonrası Pulmoner Komplikasyon Gelişen Olgular ve Tedavi Yaklaşımları. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 2 333–338.