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Ann Thorac Surg 1992;53:1052-1056
© 1992 The Society of Thoracic Surgeons

Articles

Multivariate analysis of postoperative complications after esophageal resection

Shinichi Tsutsui, MD*, Sunao Moriguchi, MD, Masaru Morita, MD, Hiroyuki Kuwano, MD, Hiroyuki Matsuda, MD, Masaki Mori, MD, Hiroshi Matsuura, MD, Keizo Sugimachi, MD

Second Department of Surgery, Faculty of Medicine, Kyushu University, Fukuoka, Japan

Accepted for publication November 27, 1991.

* Address reprint requests to Dr Tsutsui, Second Department of Surgery, Faculty of Medicine, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812, Japan.

To determine the contributing factors for eight postoperative complications after esophagectomy through a right thoracoabdominal approach, a multivariate analysis was carried out on preoperative and intraoperative variables in 141 patients with thoracic esophageal cancer. Although postoperative complications occurred in 125 patients, only 7 died of such complications. The multivariate analysis indicated that the retrosternal route was a significant factor predisposing to postoperative atclectasis. Age, preoperative arterial oxygen tension, and volume transfused were significant factors predisposing to postoperative hypoxemia, whereas age, routes other than the intrathoracic route, and volume transfused were significant factors predisposing to prolonged respiratory support. In addition, preoperative total serum bilirubin level and volume transfused were significant factors predisposing to postoperative hyperbilirubinemia; preoperative serum creatinine level was a significant contributing factor for postoperative renal insufficiency; and sex, antesternal route, and substituted colon were significant contributing factors for anastomotic leakage. There were no significant factors predisposing to postoperative pneumonia and liver dysfunction. These significant factors should be taken into consideration not only during perioperative management but also when choosing the operative procedures and extending the surgical indication for esophagectomy through a right thoracoabdominal approach.




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