Tracheobronchial injury in the setting of an esophagectomy for cancer: postoperative discovery a bad omen.

Abstract:

BACKGROUND:A tracheobronchial injury is an uncommon complication of an esophagectomy. Differences in outcomes may exist for patients with injuries detected intraoperatively and postoperatively. METHODS:A retrospective review was performed for patients who underwent an esophagectomy for cancer at Jackson Memorial Hospital/University of Miami from January 2000 to June 2012. RESULTS:An injury to the tracheobronchial tree occurred in 7 of 425 patients (1.6%). The majority of the operations were performed via a transhiatal approach (87.8%). Patients with airway injuries were older (median 73 vs. 63), more likely to have squamous cell carcinoma (85.7% vs. 17.9%), and with proximal tumors (85.7% vs. 14.1%). When given, the type of neoadjuvant treatment consisted of chemoradiotherapy in all patients who suffered an injury, whereas it was only administered to 21.3% of patients without an injury. There were no deaths among three patients in whom the injury was identified intraoperatively. Mortality occurred in three of four patients (75.0%) with an injury detected postoperatively. CONCLUSIONS:Patients with proximal tumors and radiation administration as a component of neoadjuvant treatment are more likely to suffer a tracheobronchial injury. An aggressive reoperative approach is warranted in patients with injuries that are discovered postoperatively.

journal_name

J Surg Oncol

authors

Koshenkov VP,Yakoub D,Livingstone AS,Franceschi D

doi

10.1002/jso.23577

subject

Has Abstract

pub_date

2014-06-01 00:00:00

pages

804-7

issue

8

eissn

0022-4790

issn

1096-9098

journal_volume

109

pub_type

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