Postoperative complications after minimally invasive esophagectomy in the prone position: any anesthesia-related factor?

Author:

Deana Cristian1ORCID,Vetrugno Luigi12,Stefani Francesca1,Basso Andrea2,Matellon Carola1,Barbariol Federico1,Vecchiato Massimo3,Ziccarelli Antonio3,Valent Francesca4,Bove Tiziana12,Bassi Flavio1,Petri Roberto3,De Monte Amato1

Affiliation:

1. Anesthesia and Intensive Care, Department of Anesthesia and Intensive Care, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy

2. Department of Medicine, University of Udine, Udine, Italy

3. General Surgery, Department of Surgery, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy

4. Institute of Epidemiology, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy

Abstract

Objective: To evaluate the incidence of postoperative complications arising within 30 days of minimally invasive esophagectomy in the prone position with total lung ventilation and their relationship with 30-day and 1-year mortality. Secondary outcomes included possible anesthesia-related factors linked to the development of complications. Methods: The study is a retrospective single-center observational study at the Anesthesia and Surgical Department of a tertiary care center in the northeast of Italy. Patients underwent cancer resection through esophagectomy in the prone position without one-lung ventilation. Results: We included 110 patients from January 2010 to December 2017. A total of 54% of patients developed postoperative complications that increased mortality risk at 1 year of follow-up. Complications postponed first oral intake and delayed patient discharge to home. Positive intraoperative fluid balance was related to increased mortality and the risk to develop postoperative complications. C-reactive protein at third postoperative day may help detect complication onset. Conclusions: Complication onset has a great impact on mortality after esophagectomy. Some anesthesia-related factors, mainly fluid balance, may be associated with postoperative mortality and morbidity. These factors should be carefully taken into account to obtain better outcomes after esophagectomy in the prone position without one-lung ventilation.

Publisher

SAGE Publications

Subject

Cancer Research,Oncology,General Medicine

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