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01.04.2014 | Original Article

Multi-institution retrospective study of the onset frequency of postoperative pneumonia in thoracic esophageal cancer patients

verfasst von: Yasuhiro Tsubosa, Hiroshi Sato, Yuji Tachimori, Nobukazu Hokamura, Masao Hosokawa, Yoshihiro Kinoshita, Hiroyuki Daiko, Harushi Udagawa, Masaki Ueno, Yasuyuki Seto, Keiichi Jinbo, Yuko Kitagawa, Hiroya Takeuchi, Mijong Park, Shiori Nagasaka, Hiroshi Yamada, Yojiro Ota

Erschienen in: Esophagus | Ausgabe 2/2014

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Abstract

Background

Esophagectomy for thoracic esophageal cancer is a highly invasive procedure. Most studies analyzing the risk factors for pulmonary morbidity were conducted in the early 1990s. However, previous studies did not use fixed diagnostic criteria for postoperative pneumonia and reported widely varying onset frequencies.

Purpose

To define postoperative pneumonia diagnostic criteria, clarify the onset frequency of postoperative pneumonia after esophagectomy in accordance with these criteria, and investigate the risk factors of postoperative pneumonia.

Methods

Risk factors for postoperative pneumonia were analyzed in 615 patients who underwent esophagectomy between January 2006 and December 2007 at 7 Japanese institutions using logistic regression models. The necessary criterion for a pneumonia diagnosis was an infiltrative shadow on a chest radiograph. Furthermore, a pneumonia diagnosis was based on the presence of at least 2 of the following 3 criteria: white blood count abnormalities, body temperature of 38 °C or higher, and purulent sputum.

Results

Overall, 615 patients were statistically analyzed. Pneumonia onset occurred in 66 cases (10.7 %). The risk of postoperative pneumonia was associated with a preoperative body weight loss of 5 % or more and late tracheal tube extubation.

Conclusions

This study revealed that preoperative body weight loss increased the risk of postoperative pneumonia after esophagectomy for esophageal cancer, while early-stage tracheal tube extubation reduced the risk.

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Titel: Multi-institution retrospective study of the onset frequency of postoperative pneumonia in thoracic esophageal cancer patients
verfasst von: Yasuhiro Tsubosa
Hiroshi Sato
Yuji Tachimori
Nobukazu Hokamura
Masao Hosokawa
Yoshihiro Kinoshita
Hiroyuki Daiko
Harushi Udagawa
Masaki Ueno
Yasuyuki Seto
Keiichi Jinbo
Yuko Kitagawa
Hiroya Takeuchi
Mijong Park
Shiori Nagasaka
Hiroshi Yamada
Yojiro Ota
Publikationsdatum: 01.04.2014
Verlag: Springer Japan
Erschienen in: Esophagus / Ausgabe 2/2014
Print ISSN: 1612-9059
Elektronische ISSN: 1612-9067
DOI: https://doi.org/10.1007/s10388-014-0423-y

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Multi-institution retrospective study of the onset frequency of postoperative pneumonia in thoracic esophageal cancer patients