Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2020, 164(3):284-291 | DOI: 10.5507/bp.2019.040

Complications of the surgical treatment of esophageal cancer and microbiological analysis of the respiratory tract

Radek Vrbaa, Cestmir Neorala, Katherine Vomackovaa, David Vranab, Bohuslav Melicharb, Lucie Lubuskac, Yvona Loveckovad, Rene Aujesky
a Department of Surgery, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
b Department of Oncology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
c Department of Surgical Intensive Care, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
d Department of Microbiology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic

Aim: The aim of this study was to reduce the severe respiratory complications of esophageal cancer surgery often leading to death.

Methods: Two groups of patients operated on for esophageal cancer were evaluated in this retrospective analysis. The first group was operated between 2006-2011, prior to the implementation of preoperative microbiological examination while the second group had surgery between 2012-2017 after implementation of this examination.

Results: In total, 260 patients, 220 males and 40 females underwent esophagectomy. Between 2006-2011, 113 (87.6%) males and 16 (12.4%) females and between 2012-2017, esophagectomy was performed in 107 (81.7%) males and 24 (18.3%) females. In the first cohort, 10 patients died due to respiratory complications. The 30-day mortality was 6.9% and 90-day was 9.3%. In the second cohort, 4 patients died from respiratory complications. The 30-day mortality was 1.5% and 90-day mortality was 3.1%. With regard to the incidence of respiratory complications (P=0.014), these occurred more frequently in patients with sputum collection, however, severe respiratory complications were more often observed in patients without sputum collection. Significantly fewer patients died (P=0.036) in the group with sputum collection. The incidence of respiratory complications was very significantly higher in the patients who died (P<0.0001).

Conclusion: The incidence of severe respiratory complications (causing death) may be reduced by identifying clinically silent respiratory tract infections.

Keywords: esophageal cancer, respiratory complications, mortality, morbidity, preoperative examination

Received: January 21, 2019; Revised: April 19, 2019; Accepted: August 12, 2019; Prepublished online: September 13, 2019; Published: September 17, 2020  Show citation

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Vrba, R., Neoral, C., Vomackova, K., Vrana, D., Melichar, B., Lubuska, L., Loveckova, Y., & Aujesky, R. (2020). Complications of the surgical treatment of esophageal cancer and microbiological analysis of the respiratory tract. Biomedical papers, 164(3), 284-291. doi: 10.5507/bp.2019.040
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