Perioperative Mortality in Cancer Esophagus —a Case Control Study at a High-Volume Regional Cancer Center in South India

AbstractSurgery for esophageal cancers carries high rates of morbidity and mortality despite improvements in perioperative care especially with increasingly safe anesthesia and postoperative ICU care. A case control study was conducted on 713 patients operated for esophageal cancer over a period of 8  years (2009–2016). Multiple preoperative, intraoperative, and postoperative clinical and laboratory parameters were compared between patients who succumbed to the surgery, i.e., 30-day mortality, and those who did not. Of the preoperative parameters, age >  58.5 years (p = 0.01), history of dysphagia with significant weight loss (p = 0.028), diabetes (p = 0.002), ischemic cardiac disease (p = 0.0001), low FEV1 <  69.5% (p = 0.036), preoperative length of hospital stay >  6.94 days (p = 0.001), involvement of gastroesophageal junction (p = 0.04), and ASA score >  2 (p = 0.002) were significantly associated with perioperative mortality. Intraoperatively, blood loss (p = 0.003), intraoperative (p = 0.015) and postoperative (p = 0.0001) blood transfusion, splenectomy (p = 0.0001), and excessive intraoperative intravenous fluids (p = 0.003) were associated with mortality. Decreased postoperative day 1 serum albumin level <  2.38 mg/dl (p = 0.0001), increased ICU stay >  7.32 days (SD+/- = 6.28,p = 0.03), number of positive lymph nodes >  2.97 (SD+/- = 4.19,p =...
Source: Indian Journal of Surgical Oncology - Category: Cancer & Oncology Source Type: research