Tracheobronchial lesions following oesophagectomy: prevalence, predisposing factors and outcome
Background Lesions of the trachea or main‐stem bronchi with air leakage are a grave complication of oesophagectomy. Methods Prevalence, predisposing factors and outcome of non‐malignant lesions of the trachea or main‐stem bronchi were analysed retrospectively in a consecutive series of 785 patients...
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| Veröffentlicht in: | British journal of surgery 1998-03, Vol.85 (3), p.403-406 |
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| container_title | British journal of surgery |
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| creator | Bartels, H. E. Stein, H. J. Siewert, J. R. |
| description | Background
Lesions of the trachea or main‐stem bronchi with air leakage are a grave complication of oesophagectomy.
Methods
Prevalence, predisposing factors and outcome of non‐malignant lesions of the trachea or main‐stem bronchi were analysed retrospectively in a consecutive series of 785 patients who had oesophagectomy for oesophageal cancer.
Results
Overall 31 of 785 patients developed a tracheobronchial fistula 1–30 days after oesophagectomy. Based on the location of the lesions and clinical circumstances, the tracheobronchial fistulas were thought to be due to surgical injury (four patients), cuff pressure of the tracheostomy tube (two), local peritracheal infection resulting from a cervical anastomotic leak (seven) or ‘ischaemia’ after extensive peritracheal dissection (18). On multivariate analysis, transthoracic en bloc resection (P < 0·01) and preoperative radiochemotherapy for locally advanced tumours located at or above the level of the tracheal bifurcation (P < 0·01) predisposed to this complication.
Conclusion
Non‐malignant tracheobronchial lesions are a serious complication of transthoracic oesophagectomy with extensive lymph node dissection, particularly in patients undergoing preoperative radiochemotherapy for locally advanced tumours. © 1998 British Journal of Surgery Society Ltd |
| doi_str_mv | 10.1046/j.1365-2168.1998.00579.x |
| format | Article |
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Lesions of the trachea or main‐stem bronchi with air leakage are a grave complication of oesophagectomy.
Methods
Prevalence, predisposing factors and outcome of non‐malignant lesions of the trachea or main‐stem bronchi were analysed retrospectively in a consecutive series of 785 patients who had oesophagectomy for oesophageal cancer.
Results
Overall 31 of 785 patients developed a tracheobronchial fistula 1–30 days after oesophagectomy. Based on the location of the lesions and clinical circumstances, the tracheobronchial fistulas were thought to be due to surgical injury (four patients), cuff pressure of the tracheostomy tube (two), local peritracheal infection resulting from a cervical anastomotic leak (seven) or ‘ischaemia’ after extensive peritracheal dissection (18). On multivariate analysis, transthoracic en bloc resection (P < 0·01) and preoperative radiochemotherapy for locally advanced tumours located at or above the level of the tracheal bifurcation (P < 0·01) predisposed to this complication.
Conclusion
Non‐malignant tracheobronchial lesions are a serious complication of transthoracic oesophagectomy with extensive lymph node dissection, particularly in patients undergoing preoperative radiochemotherapy for locally advanced tumours. © 1998 British Journal of Surgery Society Ltd</description><identifier>ISSN: 0007-1323</identifier><identifier>EISSN: 1365-2168</identifier><identifier>DOI: 10.1046/j.1365-2168.1998.00579.x</identifier><identifier>PMID: 9529504</identifier><identifier>CODEN: BJSUAM</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Science Ltd</publisher><subject>Adult ; Aged ; Air ; Biological and medical sciences ; Bronchial Diseases - etiology ; Esophagectomy - adverse effects ; Esophagectomy - methods ; Esophagus ; Female ; Humans ; Male ; Medical sciences ; Middle Aged ; Retrospective Studies ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the digestive system ; Time Factors ; Tracheal Diseases - etiology ; Tracheoesophageal Fistula - etiology</subject><ispartof>British journal of surgery, 1998-03, Vol.85 (3), p.403-406</ispartof><rights>1998 British Journal of Surgery Society Ltd</rights><rights>1998 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4977-13df479a80df5e4030b6cd0bc53858d7d9b43d2e8fa04db484b7ababbfd0a8f3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1046%2Fj.1365-2168.1998.00579.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1046%2Fj.1365-2168.1998.00579.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>309,310,314,780,784,789,790,1417,23930,23931,25140,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2166324$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9529504$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bartels, H. E.</creatorcontrib><creatorcontrib>Stein, H. J.</creatorcontrib><creatorcontrib>Siewert, J. R.</creatorcontrib><title>Tracheobronchial lesions following oesophagectomy: prevalence, predisposing factors and outcome</title><title>British journal of surgery</title><addtitle>Br J Surg</addtitle><description>Background
Lesions of the trachea or main‐stem bronchi with air leakage are a grave complication of oesophagectomy.
Methods
Prevalence, predisposing factors and outcome of non‐malignant lesions of the trachea or main‐stem bronchi were analysed retrospectively in a consecutive series of 785 patients who had oesophagectomy for oesophageal cancer.
Results
Overall 31 of 785 patients developed a tracheobronchial fistula 1–30 days after oesophagectomy. Based on the location of the lesions and clinical circumstances, the tracheobronchial fistulas were thought to be due to surgical injury (four patients), cuff pressure of the tracheostomy tube (two), local peritracheal infection resulting from a cervical anastomotic leak (seven) or ‘ischaemia’ after extensive peritracheal dissection (18). On multivariate analysis, transthoracic en bloc resection (P < 0·01) and preoperative radiochemotherapy for locally advanced tumours located at or above the level of the tracheal bifurcation (P < 0·01) predisposed to this complication.
Conclusion
Non‐malignant tracheobronchial lesions are a serious complication of transthoracic oesophagectomy with extensive lymph node dissection, particularly in patients undergoing preoperative radiochemotherapy for locally advanced tumours. © 1998 British Journal of Surgery Society Ltd</description><subject>Adult</subject><subject>Aged</subject><subject>Air</subject><subject>Biological and medical sciences</subject><subject>Bronchial Diseases - etiology</subject><subject>Esophagectomy - adverse effects</subject><subject>Esophagectomy - methods</subject><subject>Esophagus</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Retrospective Studies</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the digestive system</subject><subject>Time Factors</subject><subject>Tracheal Diseases - etiology</subject><subject>Tracheoesophageal Fistula - etiology</subject><issn>0007-1323</issn><issn>1365-2168</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kU9v1DAQxS0EKkvhIyDlgDiRMInt2EZcoIJCqeDQSBwt_-1mceLU3qW7356EXe1pRnq_Nxq9h1BRQ1UDad9vqhq3tGzqlle1ELwCoExU-ydodRaeohUAsLLGDX6OXuS8Aagx0OYCXQjaCApkhWSXlFm7qFMczbpXoQgu93HMhY8hxMd-vC-iy3Faq3tntnE4fCim5P6q4Ebj3i277fMU8wJ6NRMpF2q0RdxtTRzcS_TMq5Ddq9O8RN3XL93Vt_L21_X3q0-3pSGCLT9aT5hQHKynjgAG3RoL2lDMKbfMCk2wbRz3CojVhBPNlFZaewuKe3yJ3h7PTik-7FzeyqHPxoWgRhd3WTLBWjLfmsHXJ3CnB2fllPpBpYM8BTLrb066ykYFn9Ro-nzG5lxb3CzYxyP22Ad3OMs1yKUeuZFLCwvN5VKP_F-P3MvPN3cY2Gwvj_Y-b93-bFfpj2wZZlT-_nktb3607K6jXHb4HzBnlQ0</recordid><startdate>19980301</startdate><enddate>19980301</enddate><creator>Bartels, H. E.</creator><creator>Stein, H. J.</creator><creator>Siewert, J. R.</creator><general>Blackwell Science Ltd</general><general>Wiley</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>19980301</creationdate><title>Tracheobronchial lesions following oesophagectomy: prevalence, predisposing factors and outcome</title><author>Bartels, H. E. ; Stein, H. J. ; Siewert, J. R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4977-13df479a80df5e4030b6cd0bc53858d7d9b43d2e8fa04db484b7ababbfd0a8f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1998</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Air</topic><topic>Biological and medical sciences</topic><topic>Bronchial Diseases - etiology</topic><topic>Esophagectomy - adverse effects</topic><topic>Esophagectomy - methods</topic><topic>Esophagus</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Retrospective Studies</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the digestive system</topic><topic>Time Factors</topic><topic>Tracheal Diseases - etiology</topic><topic>Tracheoesophageal Fistula - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bartels, H. E.</creatorcontrib><creatorcontrib>Stein, H. J.</creatorcontrib><creatorcontrib>Siewert, J. R.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bartels, H. E.</au><au>Stein, H. J.</au><au>Siewert, J. R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Tracheobronchial lesions following oesophagectomy: prevalence, predisposing factors and outcome</atitle><jtitle>British journal of surgery</jtitle><addtitle>Br J Surg</addtitle><date>1998-03-01</date><risdate>1998</risdate><volume>85</volume><issue>3</issue><spage>403</spage><epage>406</epage><pages>403-406</pages><issn>0007-1323</issn><eissn>1365-2168</eissn><coden>BJSUAM</coden><abstract>Background
Lesions of the trachea or main‐stem bronchi with air leakage are a grave complication of oesophagectomy.
Methods
Prevalence, predisposing factors and outcome of non‐malignant lesions of the trachea or main‐stem bronchi were analysed retrospectively in a consecutive series of 785 patients who had oesophagectomy for oesophageal cancer.
Results
Overall 31 of 785 patients developed a tracheobronchial fistula 1–30 days after oesophagectomy. Based on the location of the lesions and clinical circumstances, the tracheobronchial fistulas were thought to be due to surgical injury (four patients), cuff pressure of the tracheostomy tube (two), local peritracheal infection resulting from a cervical anastomotic leak (seven) or ‘ischaemia’ after extensive peritracheal dissection (18). On multivariate analysis, transthoracic en bloc resection (P < 0·01) and preoperative radiochemotherapy for locally advanced tumours located at or above the level of the tracheal bifurcation (P < 0·01) predisposed to this complication.
Conclusion
Non‐malignant tracheobronchial lesions are a serious complication of transthoracic oesophagectomy with extensive lymph node dissection, particularly in patients undergoing preoperative radiochemotherapy for locally advanced tumours. © 1998 British Journal of Surgery Society Ltd</abstract><cop>Oxford, UK</cop><pub>Blackwell Science Ltd</pub><pmid>9529504</pmid><doi>10.1046/j.1365-2168.1998.00579.x</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | British journal of surgery, 1998-03, Vol.85 (3), p.403-406 |
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| source | MEDLINE; Access via Wiley Online Library; Oxford University Press Journals All Titles (1996-Current) |
| subjects | Adult Aged Air Biological and medical sciences Bronchial Diseases - etiology Esophagectomy - adverse effects Esophagectomy - methods Esophagus Female Humans Male Medical sciences Middle Aged Retrospective Studies Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system Time Factors Tracheal Diseases - etiology Tracheoesophageal Fistula - etiology |
| title | Tracheobronchial lesions following oesophagectomy: prevalence, predisposing factors and outcome |
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