Evaluation of Mechanical Ventilation Mean Duration and its Predicting Factors during Transhiatal Esophagectomy in Patients with Esophageal Cancer

Document Type : Original Article (s)

Authors

1 Associate Professor, Department of Thoracic Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

2 Associate Professor, Department of Thoracic Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Assistant Professor, Department of Thoracic Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

4 Assistant Professor, Department of Thoracic Surgery, School of Medicine, Lorestan University of Medical Sciences, Lorestan, Iran

5 Assistant Professor, Department of Thoracic Surgery, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran.

6 Assistant Professor, Department of Emergency Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

7 Assistant Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

8 Resident, Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

9 Resident, Medicine Education Research Center, Department of General Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

10 Assistant Professor, Department of General Surgery, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran

Abstract

Background: Esophagenctomy is the principle treatment for esophageal and gastroesophageal junction malignancies. Postoperative respiratory failure and other respiratory problems like athelectasis and severe hypoxia occur frequently after esophageal cancer surgeries. Such patients mostly need ICU care and mechanical ventilation. The aim of present study was to evaluate mean duration of mechanical ventilation and its predictor factors during esophageal resection in middle and distal esophageal cancers.Methods: This cross sectional analytic study performed in Al Zahra hospital, Isfahan on medical records of 70 patients with middle and distal esophageal cancer operated by transhiatal method in Department of Thoracic Surgery. Patient’s age, sex, tumor location, duration of mechanical ventilation, duration of operation, spirometry findings (FEV1), weight loss, need for transfusion, and serum albumin level on admission extracted from medical charts. Finally all data were analyzed by SPSS16 using chi-square and t tests.Finding: Patient’s mean age was 60.71 ± 11.81 years and 64.3% of them were men. Pathologically, 43 patients (61.4%) and 26 patients (37.1%) were diagnosed by SCC and adenocarcinoma respectively. Totally frequency of complications were 41.4%, and 7.1% of subjects were died within first 30 days. 15 patients (21.4%) were mechanically ventilated after surgery with mean duration of 1.34 day. Mean duration of mechanical ventilation showed no association with intraoperative pleural rapture, intraoperative blood transfusion, anastomosis leakage, type of pathology, postoperative anastomotic stricture, and empyema. However mean duration of mechanical ventilation were significantly higher in died patients within 30 days after surgery, reintubated subjects, patients with serum albumin level of less than 3.5 g/dl, and patients with less than 2 liter FEV1. Among quantitative variables, only FEV1 were associated with mean duration of mechanical ventilation.Conclusion: As our data showed hypoalbuminemia (which reflects subsequent malnutrition) and less than 2 liter FEV1 is correlates with prolonged mechanical ventilation (and probably more mortality) it is recommended to improve nutritional condition as well as pulmonary function preoperatively to shortened duration of mechanical ventilation and prohibit mortality rate.

Keywords

References

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Journal of Isfahan Medical School
Volume 29, Issue 125 - Serial Number 125
January and February 2011
Pages 20-27

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History

  • Receive Date: 08 February 2011
  • Revise Date: 23 May 2024
  • Accept Date: 06 April 2022

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