Residual Recurrent Nerve Paralysis After Esophagectomy is Associated with Preoperative Lower Serum Albumin

AbstractEsophagectomy for esophageal cancer is invasive thoracic surgery with a high incidence rate of postoperative complications and prolongation of hospitalization, even if the standardized clinical pathway improves the outcome (mortality and morbidity). Postoperative recurrent nerve paralysis (RNP) is related to respiratory complications concomitant with prolonged hospitalization. However, it has not been elucidated which factors affect the incidence and recovery of RNP. To detect the predictive factor for postoperative RNP, we focused on preoperative serum albumin. Patients who had esophageal cancer with standard esophagectomy were evaluated. In total, 94 patients were divided into three groups depending on the presence of RNP (46 in patients without RNP, 29 in those with transient RNP who recovered within 6 months follow-up and 19 in those with residual RNP). We retrospectively investigated factors associated with residual RNP. Preoperative lower serum albumin was associated with residual RNP. In addition, days to the resumption of oral intake and duration of stay in the hospita postoperatively were delayed in the group of residual RNP. Multiple regression analysis indicated that preoperative serum albumin was a predictive factor for residual RNP. Preoperative lower serum albumin level might be linked to residual RNP which could prolong the resumption of postoperative oral intake and shorten the period of stay at the hospital after esophagectomy, leading to unfavorable ...
Source: Dysphagia - Category: Speech Therapy Source Type: research

Related Links:

Abstract Radical esophagectomy for thoracic esophageal cancer is invasive and frequently results in postoperative pulmonary complications. Postoperative pneumonia is the most common such complication and affects hospital mortality and survival rates. Oral care has been very effective in reducing pneumonia. In Japan, preoperative professional oral care is highly recommended. However, there are few studies on the effect of preoperative improvements in oral hygiene as a result of intervention on the incidence of postoperative pneumonia. The primary end-point of this retrospective study was the incidence of postoperat...
Source: The Keio Journal of Medicine - Category: Universities & Medical Training Authors: Tags: Keio J Med Source Type: research
ConclusionsSurgical treatment is effective for most patients undergoing operative repair of PETEF, notwithstanding a significant risk of post-operative morbidity and mortality. Although fistula repair is life-saving and prevents further respiratory deterioration, return to oral alimentation is not ensured.
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
AbstractEsophagectomy remains the mainstay of curative intent treatment for esophageal cancer. Oncologic esophagectomy is a highly invasive surgery and both morbidity and mortality rates still remain high. Recently, it has been revealed that multidisciplinary perioperative management can decrease the postoperative complications after esophagectomy. In this review, we summarized the recent progress in each component of multidisciplinary perioperative care bundle, including oral hygiene, cessation of smoking and alcohol, respiratory training, measurement of physical fitness, swallowing evaluation and rehabilitation, nutritio...
Source: Esophagus - Category: Gastroenterology Source Type: research
Endosc Int Open 2018; 06: E350-E353 DOI: 10.1055/s-0043-121883 Background and study aims A 70-year-old-man underwent an esophagectomy and posterior mediastinal reconstruction for esophageal cancer that was curatively resected. Although the patient was allowed to eat after surgery, he repeatedly vomited after drinking water or eating meals and required continuous hospitalization. An upper gastrointestinal series and endoscopic examination revealed an obstruction due to the flexure of the gastric conduit, which was repeatedly treated with endoscopic balloon dilation. Endoscopic balloon dilation was completely ineffec...
Source: Endoscopy International Open - Category: Gastroenterology Authors: Tags: Case report Source Type: research
Objective: Our objective was to evaluate the impact of early oral feeding (EOF) on postoperative cardiac, respiratory, and gastrointestinal (CRG) complications after McKeown minimally invasive esophagectomy for esophageal cancer. Summary Background Data: Nil-by-mouth with enteral tube feeding is routinely practiced after esophagectomy. Methods: Patients were randomly allocated to receive oral feeding on the first postoperative day (EOF group) or late oral feeding (LOF group) 7 days after surgery. The primary endpoint was the occurrence of postoperative CRG complications, and the secondary outcomes included bowel fu...
Source: Annals of Surgery - Category: Surgery Tags: Randomized Controlled Trials Source Type: research
Conclusions Patients with anastomotic leaks had increased variance in their preoperative oral and gastric flora. Microbiome analysis could help identify patients at higher risk for leak after esophagectomy.
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
CONCLUSIONS: Patients with anastomotic leaks had increased variance in their preoperative oral and gastric flora. Microbiome analysis could help identify patients at higher risk for leak after esophagectomy. PMID: 29307454 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research
CONCLUSIONS: Serial PALs for the detection of esophageal anastomotic leaks proved to be accurate, safe, and inexpensive. Elimination of barium swallows and computed tomography scans for evaluation of anastomotic integrity may decrease aspiration risks as well as associated pulmonary failure during the postoperative period. Serial PALs may be the preferred method of detecting an anastomotic leak after esophagectomy. A prospective randomized study is warranted. PMID: 29191359 [PubMed - indexed for MEDLINE]
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research
ConclusionsTJ-100 treatment after esophageal cancer resection has the effects of prompting the recovery of gastrointestinal motility and minimizing body weight loss, and it might suppress the excess inflammatory reaction related to surgery.
Source: Esophagus - Category: Gastroenterology Source Type: research
Conclusions Serial PALs for the detection of esophageal anastomotic leaks proved to be accurate, safe, and inexpensive. Elimination of barium swallows and computed tomography scans for evaluation of anastomotic integrity may decrease aspiration risks as well as associated pulmonary failure during the postoperative period. Serial PALs may be the preferred method of detecting an anastomotic leak after esophagectomy. A prospective randomized study is warranted.
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
More News: Cancer | Cancer & Oncology | Cardiovascular & Thoracic Surgery | Esophagectomy | Esophagus Cancer | Hospitals | Oral Cancer | Respiratory Medicine | Speech-Language Pathology