Ways to reduce respiratory complications in patients with esophageal cancer after esophagectomy

Khasanov A.F.; Khoronenko V.E.; Sigal E.I.; Khasanova N.A.

doi:https://doi.org/10.17116/onkolog20187233-42

Khasanov A.F.

Respublikanskiĭ klinicheskiĭ onkologicheskiĭ dispanser Minzdrava RT, Privolzhskiĭ filial RONTs im. N.N. Blokhina RAMN, Kazan', Rossiia

Khoronenko V.E.

FGAOU VO «The First Moscow State Medical University named after I.M. Sechenov» Ministry of Health of Russia, Moscow, Russia

Sigal E.I.

Republican Clinical Cancer Center, Kazan, Republic of Tatarstan, Russia

Khasanova N.A.

Respublikanskiĭ klinicheskiĭ onkologicheskiĭ dispanser Minzdrava RT, Privolzhskiĭ filial RONTs im. N.N. Blokhina RAMN, Kazan', Rossiia

Ways to reduce respiratory complications in patients with esophageal cancer after esophagectomy

Authors:

Khasanov A.F., Khoronenko V.E., Sigal E.I., Khasanova N.A.

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Journal: P.A. Herzen Journal of Oncology. 2018;7(2): 33‑42

DOI: 10.17116/onkolog20187233-42

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To cite this article:

Khasanov AF, Khoronenko VE, Sigal EI, Khasanova NA. Ways to reduce respiratory complications in patients with esophageal cancer after esophagectomy. P.A. Herzen Journal of Oncology. 2018;7(2):33‑42. (In Russ.)
https://doi.org/10.17116/onkolog20187233-42

Подписка 2026 Онкология. Журнал им. П.А. Герцена (P.A. Herzen Journal of Oncology)

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Abstract:

Objective — to investigate risk factors for delayed emergence, late tracheal extubation, and prolonged postoperative mechanical ventilation and to determine their prognostic value for esophageal cancer patients undergoing esophagectomy. Subject and methods. A total of 177 patients with squamous cell carcinoma of the thoracic esophagus, who underwent simultaneous esophageal extirpation and esophagoplasty with the gastric stem under combined general inhalational and epidural anesthesia, were investigated. Postoperative analgesia was performed for 3—6 days with prolonged epidural block. The intermediate points of the study were to identify correlations of the period of emergence from anesthesia with the variables reflecting postoperative complications and treatment results. Its endpoints were to reveal the correlations of the period of emergence from anesthesia with the perioperative variables in a patient. A multivariate analysis was carried out to identify factors influencing the duration of postoperative emergence. Results. The increased emergence from anesthesia in a patient with esophageal cancer after esophagectomy was established to contribute to the development of postoperative complications (OR=0.187; p=0.013) and to prolonged intensive care unit stay (OR=0.369; p<0.001). Multivariate analysis has shown that the time to emerge from anesthesia in the elderly (OR=5.844; Cl 2.848 to 8.840) and in low-weight patients (OR=–3.917, Cl –6.267 to –1.567) will be slower; and thoracic epidural anesthesia as a component of anesthesia (OR=–137.261; Cl –205.622 to –68.901) and monitoring its depth with a Bispectral Index monitor (OR=–161,145, Cl –220.635 to –101.655) will substantially reduce the duration of emergence from anesthesia after esophagectomy. Conclusion. At the present stage, monitoring the course and depth of anesthesia makes it possible to optimize cardiorespiratory parameters in patients with esophageal cancer and to solve the problems of postoperative pain. This creates preconditions for early and somewhat aggressive mobilization of patients, thus decreasing the risk of postoperative complications after esophagectomy and facilitating the wide introduction of enhanced recover after surgery protocols in Russian cancer surgery.

Authors:

Khasanov A.F.

Respublikanskiĭ klinicheskiĭ onkologicheskiĭ dispanser Minzdrava RT, Privolzhskiĭ filial RONTs im. N.N. Blokhina RAMN, Kazan', Rossiia

Khoronenko V.E.

FGAOU VO «The First Moscow State Medical University named after I.M. Sechenov» Ministry of Health of Russia, Moscow, Russia

Sigal E.I.

Republican Clinical Cancer Center, Kazan, Republic of Tatarstan, Russia

Khasanova N.A.

Respublikanskiĭ klinicheskiĭ onkologicheskiĭ dispanser Minzdrava RT, Privolzhskiĭ filial RONTs im. N.N. Blokhina RAMN, Kazan', Rossiia

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