ZHOUXiao-wei , WANZhi-yu , YINJun-tai , LIXiao-ming , LUYong-guo , MOUHai-de , MEIBo
  • Department of Thoracic and Cardiovascular Surgery, Guangyuan Central Hospital, Guangyuan 628000, Sichuan, P. R. China;
WANZhi-yu, Email: kelangyanyan@163.com
Esophageal carcinoma; Perioperative period; Pneumonia; Risk factor
10.7507/1007-4848.20140186
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Objective To explore risk factors of pneumonia of patients after esophagectomy and its preventive measures. Methods Clinical data of 258 patients undergoing esophagectomy in Guangyuan Central Hospital between 2009 and 2012 were retrospectively analyzed. According to whether they had pneumonia after esophagectomy, all the 258 patients were divided into 2 groups. In the pneumonia group, there were 86 patients including 62 males and 24 females with their age of 65.1 (45-84)years, who all had pneumonia after esophagectomy. In the control group, there were 172 patients including 124 males and 48 females with their age of 60.2 (43-78)years, who didn't have pneumonia after esophagectomy. Preoperative pulmonary function, age, smoking history, anastomotic location, intraoperative blood loss, pneumonia and other perioperative complications were compared between the 2 groups. Multivariate logistic regression was performed to analyze risk factors of pneumonia after esophagectomy. Results Univariate analysis showed that incidences of moderate or severe pulmonary dysfunction, smoking history (≥400 cigarettes per year), old age (≥65 years), laryngeal recurrent nerve injury, perioperative blood loss (≥1 000 ml), operation time longer than 4 hours, and preoperative diabetes mellitus of the pneumonia group were significantly higher than those of the control group (P < 0.05). Multivariate logistic regression analysis showed that moderate or severe pulmonary dysfunction (P=0.022), smoking history (≥400 cigarettes per year, P=0.000), old age (≥65 years, P=0.026), laryngeal recurrent nerve injury (P=0.002), and perioperative blood loss (≥1000 ml, P=0.020)were main risk factors of pneumonia after esophagectomy. Conclusions Moderate or severe pulmonary dysfunction, smoking history (≥400 cigarettes per year), old age (≥65 years), laryngeal recurrent nerve injury and perioperative blood loss (≥1 000 ml)are main risk factors of pneumonia after esophagectomy. Preoperative smoking cessation, pulmonary function exercise, airway preparation, careful hemostasis, and avoidance of laryngeal recurrent nerve injury are helpful to prevent pneumonia after esophagectomy.

Citation： ZHOUXiao-wei, WANZhi-yu, YINJun-tai, LIXiao-ming, LUYong-guo, MOUHai-de, MEIBo. Risk Factor Analysis and Prevention of Pneumonia of Patients after Esophagectomy. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2014, 21(5): 649-653. doi: 10.7507/1007-4848.20140186 Copy

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