Influence of Irradiated Lung Volumes on Perioperative Morbidity and Mortality in Patients After Neoadjuvant Radiochemotherapy for Esophageal Cancer

2010 ◽  
Vol 77 (1) ◽  
pp. 44-52 ◽  
Author(s):  
Doreen Dähn ◽  
Joachim Martell ◽  
Hilke Vorwerk ◽  
Clemens F. Hess ◽  
Heinz Becker ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Morbidity And Mortality ◽  
Neoadjuvant Radiochemotherapy ◽  
Lung Volumes ◽  
Perioperative Morbidity

scholarly journals Impact of Smoking Status on Perioperative Morbidity, Mortality, and Long-Term Survival Following Transthoracic Esophagectomy for Esophageal Cancer

2021 ◽  
Author(s):  
Sivesh K. Kamarajah ◽  
Anantha Madhavan ◽  
Jakub Chmelo ◽  
Maziar Navidi ◽  
Shajahan Wahed ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Smoking Status ◽  
Pulmonary Complications ◽  
Morbidity And Mortality ◽  
Transthoracic Esophagectomy ◽  
Anastomotic Leaks ◽  
Term Survival ◽  
Long Term Survival ◽  
Perioperative Morbidity

Abstract Introduction Esophagectomy is a key component in the curative treatment of esophageal cancer. Little is understood about the impact of smoking status on perioperative morbidity and mortality and the long-term outcome of patients following esophagectomy. Objective This study aimed to evaluate morbidity and mortality according to smoking status in patients undergoing esophagectomy for esophageal cancer. Methods Consecutive patients undergoing two-stage transthoracic esophagectomy (TTE) for esophageal cancers (adenocarcinoma or squamous cell carcinoma) between January 1997 and December 2016 at the Northern Oesophagogastric Unit were included from a prospectively maintained database. The main explanatory variable was smoking status, defined as current smoker, ex-smoker, and non-smoker. The primary outcome was overall survival (OS), while secondary outcomes included perioperative complications (overall, anastomotic leaks, and pulmonary complications) and survival (cancer-specific survival [CSS], recurrence-free survival [RFS]). Results During the study period, 1168 patients underwent esophagectomy for cancer. Of these, 24% (n = 282) were current smokers and only 30% (n = 356) had never smoked. The median OS of current smokers was significantly shorter than ex-smokers and non-smokers (median 36 vs. 42 vs. 48 months; p = 0.015). However, on adjusted analysis, there was no significant difference in long-term OS between smoking status in the entire cohort. The overall complication rates were significantly higher with current smokers compared with ex-smokers or non-smokers (73% vs. 66% vs. 62%; p = 0.018), and there were no significant differences in anastomotic leaks and pulmonary complications between the groups. On subgroup analysis by receipt of neoadjuvant therapy and tumor histology, smoking status did not impact long-term survival in adjusted multivariable analyses. Conclusion Although smoking is associated with higher rates of short-term perioperative morbidity, it does not affect long-term OS, CSS, and RFS following esophagectomy for esophageal cancer. Therefore, implementation of perioperative pathways to optimize patients may help reduce the risk of complications.

Minimally Invasive Esophagectomy

2019 ◽  
pp. 308-318
Author(s):  
Brandon Merling ◽  
Frank Dupont
Keyword(s):  
Esophageal Cancer ◽  
Minimally Invasive ◽  
Minimally Invasive Esophagectomy ◽  
Anesthetic Management ◽  
Pulmonary Complications ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Perioperative Morbidity ◽  
Invasive Esophagectomy ◽  
Common Causes

Esophageal cancer is the eighth most common malignancy worldwide, producing a high morbidity and mortality rate around the globe. Minimally invasive esophagectomy (MIE) is most commonly performed on patients with this devastating disease. Esophagectomy is a high-risk procedure, and perioperative mortality remains around 5%–8%. Because esophageal cancer is associated with chronic alcohol and tobacco use, patients have serious comorbid conditions that affect anesthetic management and perioperative care. Among them, pulmonary complications and anastomotic failure remain the most common causes of perioperative morbidity and mortality. The anesthesiologist managing a patient during MIE must be able to reduce the effect of the patient’s multiple comorbidities intraoperatively while mitigating the factors that lead to adverse postoperative outcomes.

scholarly journals Venovenosus extrakorporális membránoxigenizációval (ECMO) végzett mellkassebészeti műtétek tapasztalatai Magyarországon. Retrospektív klinikai tanulmány

2019 ◽  
Vol 160 (42) ◽  
pp. 1655-1662
Author(s):  
Ildikó Madurka ◽  
Jenő Elek ◽  
Ákos Kocsis ◽  
László Agócs ◽  
Ferenc Rényi-Vámos
Keyword(s):  
Gas Exchange ◽  
Lung Resection ◽  
Lung Ventilation ◽  
Clinicopathological Characteristics ◽  
Morbidity And Mortality ◽  
Related Complication ◽  
Single Lung Ventilation ◽  
Perioperative Morbidity ◽  
Venovenous Ecmo ◽  
Vv Ecmo

Abstract: Introduction: Most modern thoracic operations are performed with single-lung ventilation balancing between convenient surgical approach and adequate gas exchange. The technical limitations include difficult airways or insufficient parenchyma for the intraoperative single-lung ventilation. Earlier, cardiopulmonary bypass was the only solution, however, today the extracorporeal membrane oxygenation is in the forefront. Aim: We retrospectively analysed our elective operations by use of venovenous ECMO to assess the indication, safety, perioperative morbidity and mortality. Patients and method: 12 patients were operated using venovenous (VV-) ECMO between 28 April 2014 and 30 April 2018 in the National Institute of Oncology. The main clinicopathological characteristics, data regarding the operation, the use of ECMO and survival were collected. Results: The mean age was 45 years, 2 patients had benign and 10 had malignant diseases. Extreme tracheal stricture was the indication for ECMO in 3 cases, while 4 patients had previous lung resection and lacked enough parenchyma for single-lung ventilation. 5 patients had both airway and parenchymal insufficiency. The average time of apnoea was 142 minutes without interruption in any of the cases. We did not experience any ECMO-related complication. We had no intraoperative death and 30-day mortality was 8.33%. Conclusion: In case of technical inoperability, when there is no airway or insufficient parenchyma for gas exchange, but pulmonary vascular bed is enough and there is no need for great-vessel resection, VV-ECMO can safely replace the complete gas exchange without further risk of bleeding. The use of VV-ECMO did not increase the perioperative morbidity and mortality. Previously inoperable patients can be operated with VV-ECMO. Orv Hetil. 2019; 160(42): 1655–1662.

scholarly journals A CASE REPORT- A CASE OF RIGHT SIDED ABSENT MAXILLA WITH ANTICIPATED DIFFICULT AIRWAY POSTED FOR PERINEAL URETHROPLATY

2020 ◽  
pp. 1-2
Author(s):  
Tanya Elizabeth Cherian ◽  
M. Sathyasuba
Keyword(s):  
Case Report ◽  
Difficult Airway ◽  
Urethral Stricture ◽  
Postoperative Recovery ◽  
Morbidity And Mortality ◽  
Video Laryngoscopy ◽  
Effective Management ◽  
Airway Control ◽  
Perioperative Morbidity ◽  
Airway Assessment

The key to success in patients with difficult airway is effective airway assessment and meticulous planning. Making use of simple and time-tested equipment and modifying these methods accordingly enable successful airway control avoiding perioperative morbidity and mortality . We report a case of 75 year old male with posterior urethral stricture planned for perineal urethroplasty with anticipated difficult airway. The airway was managed using video laryngoscopy and the procedure was uneventful with good postoperative recovery. This case report insists on making use of other conventional methods in the effective management of an anticipated difficult airway during a pandemic.

scholarly journals Perioperative Morbidity and Mortality of Patients With COVID-19 Who Undergo Urgent and Emergent Surgical Procedures

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Anne Knisely ◽  
Zhen Ni Zhou ◽  
Jenny Wu ◽  
Yongmei Huang ◽  
Kevin Holcomb ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
Morbidity And Mortality ◽  
Perioperative Morbidity
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