TY - JOUR
T1 - Predictive factors for post-operative respiratory infections after esophagectomy for esophageal cancer
T2 - Outcome of randomized trial
AU - Biere, Surya Say
AU - van Berge Henegouwen, Mark I.
AU - Bonavina, Luigi
AU - Rosman, Camiel
AU - Garcia, Josep Roig
AU - Gisbertz, Suzanne S.
AU - van der Peet, Donald L.
AU - Cuesta, Miguel A.
PY - 2017/7/1
Y1 - 2017/7/1
N2 - Background: The first and only randomized trial comparing open esophagectomy (OE) with minimally invasive esophagectomy (MIE) showed a significant lower incidence of post-operative respiratory infections in the patients who underwent MIE. In order to identify which specific factors are related to a better respiratory outcome in this trial an additional analysis was performed. Methods: This was a prospective, multicenter, randomized controlled trial. Eligible patients, with a resectable intrathoracic esophageal carcinoma, including the gastro-esophageal (GE) junction tumors and Eastern Cooperative Oncology Group ≤2, were randomized to either MIE or OE. Respiratory infection investigated was defined as a clinical manifestation of (broncho-) pneumonia confirmed by thorax X-ray and/ or Computed Tomography scan and a positive sputum culture. A logistic regression model was used. Results: From 2009 to 2011, 115 patients were randomized in 5 centers. Eight patients developed metastasis during neoadjuvant therapy or had an irresectable tumor and were therefore excluded from the analysis. Fifty-two OE patients were comparable to 55 MIE patients with regard to baseline characteristics. In-hospital mortality was not significantly different [2% (open group) and 4% (MIE group)]. A body mass index (BMI) ≥26 and OE were associated with a roughly threefold risk of developing a respiratory infection. Conclusions: Overweight patients and OE are independently associated with a significant higher incidence of post-operative respiratory infections, i.e., pneumonia.
AB - Background: The first and only randomized trial comparing open esophagectomy (OE) with minimally invasive esophagectomy (MIE) showed a significant lower incidence of post-operative respiratory infections in the patients who underwent MIE. In order to identify which specific factors are related to a better respiratory outcome in this trial an additional analysis was performed. Methods: This was a prospective, multicenter, randomized controlled trial. Eligible patients, with a resectable intrathoracic esophageal carcinoma, including the gastro-esophageal (GE) junction tumors and Eastern Cooperative Oncology Group ≤2, were randomized to either MIE or OE. Respiratory infection investigated was defined as a clinical manifestation of (broncho-) pneumonia confirmed by thorax X-ray and/ or Computed Tomography scan and a positive sputum culture. A logistic regression model was used. Results: From 2009 to 2011, 115 patients were randomized in 5 centers. Eight patients developed metastasis during neoadjuvant therapy or had an irresectable tumor and were therefore excluded from the analysis. Fifty-two OE patients were comparable to 55 MIE patients with regard to baseline characteristics. In-hospital mortality was not significantly different [2% (open group) and 4% (MIE group)]. A body mass index (BMI) ≥26 and OE were associated with a roughly threefold risk of developing a respiratory infection. Conclusions: Overweight patients and OE are independently associated with a significant higher incidence of post-operative respiratory infections, i.e., pneumonia.
KW - Esophagectomy
KW - Minimally invasive
KW - Obesity
KW - Open esophagectomy (OE)
KW - Pneumonia
KW - Respiratory infections
UR - http://www.scopus.com/inward/record.url?scp=85025815020&partnerID=8YFLogxK
U2 - https://doi.org/10.21037/jtd.2017.06.61
DO - https://doi.org/10.21037/jtd.2017.06.61
M3 - Article
C2 - 28815084
SN - 2072-1439
VL - 9
SP - S861-S867
JO - Journal of thoracic disease
JF - Journal of thoracic disease
IS - 8
ER -