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01.04.2014 | Original Article

Predictive factors for postoperative tachyarrhythmia after thoracoscopic esophagectomy and the usefulness of landiolol hydrochloride for its treatment

verfasst von: Koichi Okamoto, Itasu Ninomiya, Shogo Maruzen, Hiroto Saito, Tomoya Tsukada, Jun Kinoshita, Isamu Makino, Keishi Nakamura, Katsunobu Oyama, Tomoharu Miyashita, Hidehiro Tajima, Hiroyuki Takamura, Hirohisa Kitagawa, Sachio Fushida, Takashi Fujimura, Tetsuo Ohta

Erschienen in: Esophagus | Ausgabe 2/2014

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Abstract

Background

Tachyarrhythmia after esophagectomy is a severe complication that should not be underestimated because of its negative impact. The aims of this study were to clarify the cause and impact of postoperative tachyarrhythmia after thoracoscopic esophagectomy. Additionally, we analyzed the usefulness of landiolol administration for postoperative tachyarrhythmia.

Methods

We evaluated the predictive factors for tachyarrhythmia onset after surgery and its clinical impact in 127 patients who underwent thoracoscopic esophagectomy with extended lymphadenectomy. Moreover, we analyzed the efficacy of landiolol for postoperative tachyarrhythmia.

Results

Tachyarrhythmia developed in 38 of the 127 patients. Multivariate analysis showed that advanced age, heart disease, and hyperlipidemia were associated with postoperative tachyarrhythmia. Hyponatremia, hypoalbuminemia, and leukocytosis on postoperative day 3 were significantly associated with tachyarrhythmia onset. The incidence of all complications and respiratory complications, including pneumonia, was significantly higher in patients with than in those without tachyarrhythmia. The mortality rate in the tachyarrhythmia group tended to be higher than that in the nontachyarrhythmia group. Landiolol as a treatment for tachyarrhythmia immediately decreased heart rate and safely reduced subsequent respiratory complications.

Conclusion

In elderly patients with cardiac disease or hyperlipidemia, surgeons should be alert for the occurrence of tachyarrhythmia after esophagectomy. Postoperative tachyarrhythmia is a marker of morbidities with particular emphasis on respiratory complications. However, it can be adequately managed by landiolol, resulting in fewer respiratory complications. Landiolol might be a safe and convenient agent for managing postoperative tachyarrhythmia after thoracoscopic esophagectomy, resulting in lower mortality and morbidity rates.

Amar D. Postthoracotomy atrial fibrillation. Curr Opin Anaesthesiol. 2007;20:43–7.PubMedCrossRef

Narayan SM, Cain ME, Smith JM. Atrial fibrillation. Lancet. 1997;350:943–50.PubMedCrossRef

Mathew JP, Parks R, Savino JS, Friedman AS, Koch C, Mangano DT, et al. Atrial fibrillation following coronary artery bypass graft surgery: predictors, outcomes, and resource utilization. MultiCenter Study of Perioperative Ischemia Research Group. JAMA. 1996;276:300–6.PubMedCrossRef

Aranki SF, Shaw DP, Adams DH, Rizzo RJ, Couper GS, VanderVliet M, et al. Predictors of atrial fibrillation after coronary artery surgery. Current trends and impact on hospital resources. Circulation. 1996;94:390–7.PubMedCrossRef

De Decker K, Jorens PG, Van Schil P. Cardiac complications after noncardiac thoracic surgery: an evidence-based current review. Ann Thorac Surg. 2003;75:1340–8.PubMedCrossRef

von Knorring J, Lepantalo M, Lindgren L, Lindfors O. Cardiac arrhythmias and myocardial ischemia after thoracotomy for lung cancer. Ann Thorac Surg. 1992;53:642–7.CrossRef

Dyszkiewicz W, Skrzypczak M. Atrial fibrillation after surgery of the lung: clinical analysis of risk factors. Eur J Cardiothorac Surg. 1998;13:625–8.PubMedCrossRef

Rena O, Papalia E, Oliaro A, Casadio C, Ruffini E, Filosso PL, et al. Supraventricular arrhythmias after resection surgery of the lung. Eur J Cardiothorac Surg. 2001;20:688–93.PubMedCrossRef

Curtis JJ, Parker BM, McKenney CA, Wagner-Mann CC, Walls JT, Demmy TL, et al. Incidence and predictors of supraventricular dysrhythmias after pulmonary resection. Ann Thorac Surg. 1998;66:1766–71.PubMedCrossRef

10.

Vaporciyan AA, Correa AM, Rice DC, Roth JA, Smythe WR, Swisher SG, et al. Risk factors associated with atrial fibrillation after noncardiac thoracic surgery: analysis of 2588 patients. J Thorac Cardiovasc Surg. 2004;127:779–86.PubMedCrossRef

11.

Atkins BZ, Shah AS, Hutcheson KA, Mangum JH, Pappas TN, Harpole DH, Jr, et al. Reducing hospital morbidity and mortality following esophagectomy. Ann Thorac Surg. 2004;78:1170–6 (discussion –6).

12.

Murthy SC, Law S, Whooley BP, Alexandrou A, Chu KM, Wong J. Atrial fibrillation after esophagectomy is a marker for postoperative morbidity and mortality. J Thorac Cardiovasc Surg. 2003;126:1162–7.PubMedCrossRef

13.

Ma JY, Wang Y, Zhao YF, Wu Z, Liu LX, Kou YL, et al. Atrial fibrillation after surgery for esophageal carcinoma: clinical and prognostic significance. World J Gastroenterol. 2006;12:449–52.PubMed

14.

Stawicki SP, Prosciak MP, Gerlach AT, Bloomston M, Davido HT, Lindsey DE, et al. Atrial fibrillation after esophagectomy: an indicator of postoperative morbidity. Gen Thorac Cardiovasc Surg. 2011;59:399–405.PubMedCrossRef

15.

Muller JM, Erasmi H, Stelzner M, Zieren U, Pichlmaier H. Surgical therapy of oesophageal carcinoma. Br J Surg. 1990;77:845–57.PubMedCrossRef

16.

Bartels H, Stein HJ, Siewert JR. Preoperative risk analysis and postoperative mortality of oesophagectomy for resectable oesophageal cancer. Br J Surg. 1998;85:840–4.PubMedCrossRef

17.

Akiyama H, Tsurumaru M, Udagawa H, Kajiyama Y. Radical lymph node dissection for cancer of the thoracic esophagus. Ann Surg. 1994;220:364–72 (discussion 72–3).

18.

Fujita H, Kakegawa T, Yamana H, Shima I, Toh Y, Tomita Y, et al. Mortality and morbidity rates, postoperative course, quality of life, and prognosis after extended radical lymphadenectomy for esophageal cancer. Comparison of three-field lymphadenectomy with two-field lymphadenectomy. Ann Surg. 1995;222:654–62.PubMedCentralPubMedCrossRef

19.

Cuschieri A, Shimi S, Banting S. Endoscopic oesophagectomy through a right thoracoscopic approach. J R Coll Surg Edinb. 1992;37:7–11.PubMed

20.

Osugi H, Takemura M, Higashino M, Takada N, Lee S, Kinoshita H. A comparison of video-assisted thoracoscopic oesophagectomy and radical lymph node dissection for squamous cell cancer of the oesophagus with open operation. Br J Surg. 2003;90:108–13.PubMedCrossRef

21.

Mooss AN, Wurdeman RL, Mohiuddin SM, Reyes AP, Sugimoto JT, Scott W, et al. Esmolol versus diltiazem in the treatment of postoperative atrial fibrillation/atrial flutter after open heart surgery. Am Heart J. 2000;140:176–80.PubMedCrossRef

22.

Suzuki S, Morimatsu H, Egi M, Shimizu K, Matsusaki T, Sato T, et al. Effect of landiolol on postoperative atrial fibrillation in 7 patients undergoing esophagectomy. J Jpn Soc Intensive Care Med. 2011;18:215–20.CrossRef

23.

Seishima R, Koyanagi K, Nakagawa M, Nagase T, Okabayashi K, Tabuchi S, et al. Usefulness of short-acting β1 selective blocker (landiolol hydrochloride) for postoperative tachyarrhythmia after radical operation of esophageal cancer. Jpn J Gastroenterol Surg. 2010;43:990–5.CrossRef

24.

Owens WD, Felts JA, Spitznagel EL Jr. ASA physical status classifications: a study of consistency of ratings. Anesthesiology. 1978;49:239–43.PubMedCrossRef

25.

Sobin LH, Gospodarowicz M, Wittekind C. International Union Against Cancer (UICC). TNM Classification of Malignant Tumours, 7th edn. Hoboken: Wiley-Blackwell; 2010.

26.

Ninomiya I, Osugi H, Fujimura T, Kayahara M, Takamura H, Takemura M, et al. Results of video-assisted thoracoscopic surgery for esophageal cancer during the induction period. Gen Thorac Cardiovasc Surg. 2008;56:119–25.PubMedCrossRef

27.

Watanabe M, Baba Y, Nagai Y, Baba H. Minimally invasive esophagectomy for esophageal cancer: an updated review. Surg Today. 2012;43:237–44.PubMedCrossRef

28.

Krowka MJ, Pairolero PC, Trastek VF, Payne WS, Bernatz PE. Cardiac dysrhythmia following pneumonectomy. Clinical correlates and prognostic significance. Chest. 1987;91:490–5.PubMedCrossRef

29.

Wahi R, McMurtrey MJ, DeCaro LF, Mountain CF, Ali MK, Smith TL, et al. Determinants of perioperative morbidity and mortality after pneumonectomy. Ann Thorac Surg. 1989;48:33–7.PubMedCrossRef

30.

Brathwaite D, Weissman C. The new onset of atrial arrhythmias following major noncardiothoracic surgery is associated with increased mortality. Chest. 1998;114:462–8.PubMedCrossRef

31.

Whooley BP, Law S, Murthy SC, Alexandrou A, Wong J. Analysis of reduced death and complication rates after esophageal resection. Ann Surg. 2001;233:338–44.PubMedCentralPubMedCrossRef

32.

Mio Y. New ultra-short-acting β1-blockers: landiolol and esmolol. The Effects on cardiovascular system. Masui. 2006;55:841–8.PubMed

33.

Tanaka K. Effect of landiolol on hemodynamic improvement and prevention of infusion of atrial fibrillation in the perioperative period of off-pump coronary artery bypass grafting. Kyobu Geka. 2010;63:175–83.PubMed

34.

Wakamatsu H, Takase S, Sato Y, Seto Y, Kurosawa H, Yokoyama H. Effect of intra-operative low-dose infusion of landiolol hydrochloride on post-operative atrial fibrillation after off-pump coronary artery bypass grafting. Kyobu Geka. 2010;63:764–8.PubMed

35.

Sezai A, Minami K, Nakai T, Hata M, Yoshitake I, Wakui S, et al. Landiolol hydrochloride for prevention of atrial fibrillation after coronary artery bypass grafting: new evidence from the PASCAL trial. J Thorac Cardiovasc Surg. 2011;141:1478–87.PubMedCrossRef

36.

Fuster V, Ryden LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA, et al. ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: full text: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 guidelines for the management of patients with atrial fibrillation) developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Europace. 2006;8:651–745.PubMedCrossRef

37.

Okita T, Uji M, Shinjo T, Morioka M, Kumano H, Ishimura N, et al. Use of landiolol hydrochloride for the prevention of atrial fibrillation after lung resection. Masui. 2008;57:953–8.PubMed

38.

Nezu K, Ogawa F, Matsui Y, Amano H, Hara H, Kurouzu N, et al. Effect of postoperative low-dose landiolol hydrochloride for the prevention of tachyarrhythmia after primary lung cancer surgery. Jpn J Chest Surg. 2011;25:472–8.CrossRef

Titel: Predictive factors for postoperative tachyarrhythmia after thoracoscopic esophagectomy and the usefulness of landiolol hydrochloride for its treatment
verfasst von: Koichi Okamoto
Itasu Ninomiya
Shogo Maruzen
Hiroto Saito
Tomoya Tsukada
Jun Kinoshita
Isamu Makino
Keishi Nakamura
Katsunobu Oyama
Tomoharu Miyashita
Hidehiro Tajima
Hiroyuki Takamura
Hirohisa Kitagawa
Sachio Fushida
Takashi Fujimura
Tetsuo Ohta
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/s10388-013-0402-8

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Predictive factors for postoperative tachyarrhythmia after thoracoscopic esophagectomy and the usefulness of landiolol hydrochloride for its treatment