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Postoperative pulmonary complications in patients with esophageal cancer

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Summary

There are recent reports on postoperative pulmonary complications in patients with esophageal cancer who were treated preoperatively with chemotherapy and irradiation. The Hamburg Esophageal Study Group is currently undertaking a prospective randomized study to evaluate the efficacy of preoperative treatment. Postoperative pulmonary complications and mortality in these patients with either a combined preoperative treatment (group 1, n=11) or chemotherapy alone (group 2, n=9) are evaluated in the present paper. Complete remission of the tumor was found more often in group 1 (54,6%) than in group 2 (22.2%). However, postoperatively the patients of group 1 developed adult respiratory distress syndrome (ARDS; 54,6%) more frequently than in group 2 (11.1%), and all patients with ARDS died. Thus, although the combined preoperative treatment is more effective in tumor remission, it is associated with a higher respiratory failure and postoperative mortality. Therefore, the preoperative regime has now been changed by the study group. Since after the clinical manifestation of ARDS no causative clinical therapy is available up to now, attention must be focused on the prevention of respiratory failure.

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Abbreviations

ARDS:

adult respiratory distress syndrome

FiO2 :

inspired fraction of oxygen

References

  1. Allen SC, Riddell GS, Butchart EG (1981) Bleomycin therapy and anesthesia: the possible hazards of oxygen administration to patients after treatment with bleomycin. Anaesthesia 36:60–63

    Google Scholar 

  2. Andreadis N, Petty TL (1985) Adult respiratory distress syndrome. Problems and progress. Am Rev Resp Dis 132:1344–1346

    Google Scholar 

  3. Ashbaugh DG, Bigelow DB, Petty TL, Levine BE (1967) Acute respiratory distress in adults. Lancet II:319–323

    Google Scholar 

  4. Deneke S, Fanburg B (1980) Normobaric oxygen toxicity of the lung. N Engl J Med 303:76–86

    Google Scholar 

  5. Dunnick NR, Schwade JG, Martin SE, Johnston MR, Glatstein E (1982) Interstitial pulmonary infiltrate following combined therapy for esophageal carcinoma. Chest 81:453–456

    Google Scholar 

  6. Earlam R, Cunha-Melo JR (1980) Oesophageal squamous cell carcinoma. I. A critical review of surgery. Br J Surg 67:381–390

    Google Scholar 

  7. Earlam R, Cunha-Melo JR (1980) Oesophageal squamous cell carcinoma. II. A critical review of radiotherapy. Br J Surg 67:457–461

    Google Scholar 

  8. Franklin R, Steiger Z, Vaishampayan G, Asfaw I, Rosenberg J, Loh J, Hoschner J, Miller P (1983) Combined modality therapy for esophageal squamous cell carcinoma. Cancer 51:1062–1071

    Google Scholar 

  9. Fujimaki M, Soga J, Wada K, Kawaguchi M, Maeda M, Sasaki K, Omori Y, Muto T (1972) A new chemotherapy as a preoperative treatment for esophageal cancer surgery. Acta Med Biol 19:181–191

    Google Scholar 

  10. Gilson AJ, Sahn SA (1985) Reactivation of bleomycin lung toxicity following oxygen administration. Chest 88:304–306

    Google Scholar 

  11. Hickling KG (1990) Ventilatory management of ARDS: can it affect the outcome? Intensive Care Med 16:219–226

    Google Scholar 

  12. Kelson DP (1988) Preoperative chemotherapy or concurrent chemotherapy and radiation in esophageal cancer. In: Siewert JR, Hölscher AH (eds) Diseases of the esophageus. Springer, Berlin Heidelberg New York, 301–307

    Google Scholar 

  13. Kido Y, Ogawa Y, Kawasaki K, Shiozaki H, Morimoto S, Mori T (1988) Pulmonary complications following surgery for esophageal cancer. In: Siewert JR, Holscher AH (eds) Diseases of the esophagus. Springer, Berlin Heidelberg New York, pp 229–231

    Google Scholar 

  14. Kirby RR, Civetta JM (1988) Critical care. In: Brown DL (ed) Risk and outcome in anesthesia. Lippincott, Philadelphia

    Google Scholar 

  15. Kox W, Bihari D (1988) Shock and the adult respiratory distress syndrome. Springer Berlin Heidelberg New York

    Google Scholar 

  16. Nygaard K, Smith-Erichsen N, Haltevoll R, Refsum SB (1978) Pulmonary complications after bleomycin, irradiation and surgery for esophageal cancer. Cancer 41:17–22

    Google Scholar 

  17. Ries G, Kneschaurek P, Emslander HP, Bader M, Dittler HJ, Bertermann O, Pfänder K, Worbs K (1986) Erste Ergebnisse des alleinigen oder mit Laserbehandlung kombinierten High-dose-rate-192Iridium-Afterloadingverfahrens bei Tumoren des Respirations- und oberen Digestivtraktes. Strahlenther Onkol 162:555–560

    Google Scholar 

  18. Schray MF, McDougall JC, Martinez A, Edmundson GK, Cortese DA (1985) Management of malignant airway obstruction. Clinical and dosimetric considerations using an iridium-192 afterloading technique in conjunction with the neodymium-YAG-laser. Int J Rad Onkol Biol Phys 11:403–409

    Google Scholar 

  19. Shapiro JM, Mihm FG, Trudell JR, Stevens JH, Feeley TW (1987) Leukotriene D4 increases extravascular lung water in the dog. Circ Shock 21:121

    Google Scholar 

  20. Steiger Z, Franklin R, Wilson RF, Leichman L, Seydel H, Loh JJK, Vaishamapayan G, Knechtges T, Asfaw I, Dindogru A, Rosenberg JC, Buroker T, Torres A, Hoschner D, Miller P, Pietruk T, Vaitkevicius V (1981) Eradication and palliation of squamous cell carcinoma of the esophagus with chemotherapy, radiotherapy, and surgical therapy. J Thor Cardiovasc Surg 82:713–719

    Google Scholar 

  21. Weigelt JA (1989) Acute respiratory failure: current concepts. In: Vincent JL (ed) Update in intensive care and emergency medicine. Springer, Berlin Heidelberg New York, pp 51–57

    Google Scholar 

  22. White DA, Stover DE (1984) Severe bleomycin-induced pneumonitis. Clinical features and responses to corticosteroids. Chest 86:723–728

    Google Scholar 

  23. Witschi H, Haschek W, Klein-Szanto A, Hakkinen P (1981) Potentiation of diffuse lung damage by oxygen determining variables. Am Rev Resp Dis 123:98–103

    Google Scholar 

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Members of the Hamburg esophageal study group: Prof. Hossfeld, Prof. Weh, Prof. Hübener, Dr. Krüll, Dr. Schwarz, PD Dr. Grimm, Dr. Küchler, Dr. Grauel, Dr. Holst, Dr. Maas, Prof. Dürig, Prof. Kremer, Dr. Steinhöfel, PD Dr. Hamper

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Scholz, J., Steinhöfel, U., Dürig, M. et al. Postoperative pulmonary complications in patients with esophageal cancer. Clin Investig 71, 294–298 (1993). https://doi.org/10.1007/BF00184730

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  • DOI: https://doi.org/10.1007/BF00184730

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