Impact of chronic obstructive pulmonary disease on postoperative complications and short-term prognosis in patients undergoing oesophagectomy_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LEI Kai , FENG Tianci , ZHAO Zheng ,  WANG Xiaowen ,  HUANG Chun , WU Qingchen

Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, P. R. China;

Corresponding?author：

WANG Xiaowen, Email: xiaowenwang@yeah.net; HUANG Chun, Email: hcsurgery@163.com

Keywords：

Chronic obstructive pulmonary disease; esophageal neoplasms; postoperative complications; survival analysis; surgery

DOI：

10.7507/1007-4848.202009042

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To provide clinical reference for the perioperative management of esophageal cancer patients with different stages of chronic obstructive pulmonary disease (COPD) through investigating the impact of COPD on postoperative complications and survival in esophageal cancer patients undergoing oesophagectomy.Methods The clinical data of 163 patients who underwent radical resection of esophageal cancer in our department from January 2015 to January 2018 were retrospectively analyzed, including 124 males and 39 females, with a median age of 64 years (IQR: 23.8 years). They were divided into a COPD group (n=87) and a non-COPD group (n=76) according to the presence of COPD before operation. The clinical data were collected and the postoperative complications and 2-year survival between the two groups were compared and analyzed.Results The incidence of major postoperative complications (pulmonary infection, respiratory failure, arrhythmia and anastomotic leakage) in the COPD group were higher than those in the non-COPD group (all P<0.05). Spearman correlation analysis showed that the severity of preoperative COPD was positively correlated with the incidence of postoperative complications in patients with esophageal cancer (r=0.437, P<0.001). The incidence of postoperative respiratory failure and mortality in patients with severe COPD were significantly higher than those in patients without COPD and those with mild or moderate COPD. The 2-year survival rate of patients with esophageal cancer in the COPD group was lower than that in the non-COPD group (56.1% vs. 78.5.%, P=0.001), and the severity of COPD was negatively correlated to the survival rate.Conclusion COPD significantly increases the incidence of postoperative complications in patients with esophageal cancer, which is not conducive to the prognosis of patients, and the severity of COPD is correlated with postoperative complications and 2-year survival rate.

Citation： LEI Kai, FENG Tianci, ZHAO Zheng, WANG Xiaowen, HUANG Chun, WU Qingchen. Impact of chronic obstructive pulmonary disease on postoperative complications and short-term prognosis in patients undergoing oesophagectomy. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2022, 29(2): 200-205. doi: 10.7507/1007-4848.202009042 Copy

1.	WHO. Global burden of disease website. [2020-10-15]. http:/www.who.int/topics/global_burden of disease.
2.	GOLD. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. [2020-08-09]. https://goldcopd.org/gold-reports/.
3.	Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
4.	戴偉, 王小文, 黃春, 等. 肺癌切除術后心房顫動發生的危險因素及發病機制研究進展. 上海交通大學學報(醫學版), 2018, 38(5): 573-577.
5.	王小文, 黃春, 葛明建, 等. 胸腔鏡手術與傳統開胸術后心律失常發生率的前瞻性對比研究. 中華胸心血管外科學雜志, 2013, 29(1): 4-7.
6.	陳偉, 馮天賜, 王小文, 等. 合并2型糖尿病的非小細胞肺癌患者肺切除術后近期預后的臨床分析. 中國胸心血管外科臨床雜志, 2020, 27(8): 912-917.
7.	孫芳艷, 錢培芬. 慢性阻塞性肺疾病綜合肺康復方案的研究進展. 中華護理雜志, 2010, 45(8): 755-757.
8.	Krzystek-Korpacka M, Matusiewicz M, Diakowska D, et al. Respiratory insufficiency related to COPD accelerates systemic inflammation, under-nutrition, and angiogenesis in esophageal malignancies. Exp Oncol, 2008, 30(1): 75-80.
9.	Aggarwal BB, Shishodia S, Sandur SK, et al. Inflammation and cancer: how hot is the link? Biochem Pharmacol, 206, 72(11): 1605-1621.
10.	Oudijk EJ, Lammers JW, Koenderman L. Systemic inflammation in chronic obstructive pulmonary disease. Eur Respir J Suppl, 2003, 46: 5s-13s.
11.	崔玉尚, 張志庸, 阿伊都·阿布都熱伊木. 開胸術后早期肺功能的變化規律及影響因素分析. 中華外科雜志, 2003, 41(12): 909-912.
12.	Kageyama S, Ikeda H, Miyahara Y, et al. Adoptive transfer of MAGE-A4 t-cell receptor gene-transduced lymphocytes in patients with recurrent esophageal cancer. Clin Cancer Res, 2015, 21(10): 2268-2277.
13.	Ferguson MK, Celauro AD, Prachand V. Prediction of major pulmonary complications after esophagectomy. Ann Thorac Surg, 2011, 91(5): 1494-1500.
14.	Ma G, Zhang X, Ma Q, et al. A novel multivariate scoring system for determining the prognosis of lymph node-negative esophageal squamous cell carcinoma following surgical therapy: An observational study. Eur J Surg Oncol, 2015, 41(4): 541-547.
15.	Markar S, Gronnier C, Duhamel A, et al. Pattern of postoperative mortality after esophageal cancer resection according to center volume: Results from a large european multicenter study. Ann Surg Oncol, 2015, 22(8): 2615-2623.
16.	Yoshida R, Morita M, Shoji F, et al. Clinical significance of SIP1 and E-cadherin in patients with esophageal squamous cell carcinoma. Ann Surg Oncol, 2015, 22(8): 2608-2614.
17.	劉現海, 李峰, 路宏燕, 等. 肺功能指標對食管癌患者術后肺部感染的預測價值. 中華醫院感染學雜志, 2019, 29(9): 1379-1383.
18.	于善海, 李德生, 伊力亞爾·夏合丁, 等. 食管癌切除術后并發癥多因素 Logistic 回歸分析及風險模型建立. 世界華人消化雜志, 2011, 19(34): 3508-3513.
19.	陳曉珍, 張懷忠, 方韜. 食管癌術后并發癥危險因素的 Logistic 分析及護理干預. 中國藥物與臨床, 2014, 14(3): 300-302.
20.	Ohi M, Toiyama Y, Omura Y, et al. Risk factors and measures of pulmonary complications after thoracoscopic esophagectomy for esophageal cancer. Surg Today, 2019, 49(2): 176-186.
21.	田燁, 周凌霄, 任光國. 1208 例食管癌患者術后吻合口瘺風險因素分析. 重慶醫學, 2014, 43(15): 1924-1927.
22.	沈偉忠, 黃建峰. 食管癌術后心律失常危險因素分析. 中國腫瘤外科雜志, 2015, 7(6): 384-386.
23.	楊澤山. 431 例老年食管癌患者術后肺部并發癥情況及危險因素分析. 中華全科醫學, 2015, 13(11): 1779-1781, 1868.
24.	楊立新, 梁偉, 于嬋娟, 等. 胸腹腔鏡聯合食管癌根治術后肺部并發癥的危險因素分析. 臨床外科雜志, 2017, 25(7): 512-515.
25.	許冰. 食管癌、賁門癌術后心律失常的原因分析. 腫瘤基礎與臨床, 2012, 25(1): 40-42.
26.	郝棟, 劉國魁, 邱新民. 低肺功能食管癌高齡患者的圍術期治療探討. 白求恩軍醫學院學報, 2009, 7(4): 219-220.
27.	沙紀名, 林澤邦, 徐盛松, 等. 臨界肺功能食管癌患者微創手術的臨床療效研究. 安徽醫學, 2019, 40(8): 917-920.
28.	Noguchi T, Shichinohe T, Hirano S, et al. Minimally invasive esophagectomy for cancer patients with low pulmonary function. Hepatogastroenterology, 2010, 57(101): 768-771.

1. WHO. Global burden of disease website. [2020-10-15]. http:/www.who.int/topics/global_burden of disease.
2. GOLD. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. [2020-08-09]. https://goldcopd.org/gold-reports/.
3. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
4. 戴偉, 王小文, 黃春, 等. 肺癌切除術后心房顫動發生的危險因素及發病機制研究進展. 上海交通大學學報(醫學版), 2018, 38(5): 573-577.
5. 王小文, 黃春, 葛明建, 等. 胸腔鏡手術與傳統開胸術后心律失常發生率的前瞻性對比研究. 中華胸心血管外科學雜志, 2013, 29(1): 4-7.
6. 陳偉, 馮天賜, 王小文, 等. 合并2型糖尿病的非小細胞肺癌患者肺切除術后近期預后的臨床分析. 中國胸心血管外科臨床雜志, 2020, 27(8): 912-917.
7. 孫芳艷, 錢培芬. 慢性阻塞性肺疾病綜合肺康復方案的研究進展. 中華護理雜志, 2010, 45(8): 755-757.
8. Krzystek-Korpacka M, Matusiewicz M, Diakowska D, et al. Respiratory insufficiency related to COPD accelerates systemic inflammation, under-nutrition, and angiogenesis in esophageal malignancies. Exp Oncol, 2008, 30(1): 75-80.
9. Aggarwal BB, Shishodia S, Sandur SK, et al. Inflammation and cancer: how hot is the link? Biochem Pharmacol, 206, 72(11): 1605-1621.
10. Oudijk EJ, Lammers JW, Koenderman L. Systemic inflammation in chronic obstructive pulmonary disease. Eur Respir J Suppl, 2003, 46: 5s-13s.
11. 崔玉尚, 張志庸, 阿伊都·阿布都熱伊木. 開胸術后早期肺功能的變化規律及影響因素分析. 中華外科雜志, 2003, 41(12): 909-912.
12. Kageyama S, Ikeda H, Miyahara Y, et al. Adoptive transfer of MAGE-A4 t-cell receptor gene-transduced lymphocytes in patients with recurrent esophageal cancer. Clin Cancer Res, 2015, 21(10): 2268-2277.
13. Ferguson MK, Celauro AD, Prachand V. Prediction of major pulmonary complications after esophagectomy. Ann Thorac Surg, 2011, 91(5): 1494-1500.
14. Ma G, Zhang X, Ma Q, et al. A novel multivariate scoring system for determining the prognosis of lymph node-negative esophageal squamous cell carcinoma following surgical therapy: An observational study. Eur J Surg Oncol, 2015, 41(4): 541-547.
15. Markar S, Gronnier C, Duhamel A, et al. Pattern of postoperative mortality after esophageal cancer resection according to center volume: Results from a large european multicenter study. Ann Surg Oncol, 2015, 22(8): 2615-2623.
16. Yoshida R, Morita M, Shoji F, et al. Clinical significance of SIP1 and E-cadherin in patients with esophageal squamous cell carcinoma. Ann Surg Oncol, 2015, 22(8): 2608-2614.
17. 劉現海, 李峰, 路宏燕, 等. 肺功能指標對食管癌患者術后肺部感染的預測價值. 中華醫院感染學雜志, 2019, 29(9): 1379-1383.
18. 于善海, 李德生, 伊力亞爾·夏合丁, 等. 食管癌切除術后并發癥多因素 Logistic 回歸分析及風險模型建立. 世界華人消化雜志, 2011, 19(34): 3508-3513.
19. 陳曉珍, 張懷忠, 方韜. 食管癌術后并發癥危險因素的 Logistic 分析及護理干預. 中國藥物與臨床, 2014, 14(3): 300-302.
20. Ohi M, Toiyama Y, Omura Y, et al. Risk factors and measures of pulmonary complications after thoracoscopic esophagectomy for esophageal cancer. Surg Today, 2019, 49(2): 176-186.
21. 田燁, 周凌霄, 任光國. 1208 例食管癌患者術后吻合口瘺風險因素分析. 重慶醫學, 2014, 43(15): 1924-1927.
22. 沈偉忠, 黃建峰. 食管癌術后心律失常危險因素分析. 中國腫瘤外科雜志, 2015, 7(6): 384-386.
23. 楊澤山. 431 例老年食管癌患者術后肺部并發癥情況及危險因素分析. 中華全科醫學, 2015, 13(11): 1779-1781, 1868.
24. 楊立新, 梁偉, 于嬋娟, 等. 胸腹腔鏡聯合食管癌根治術后肺部并發癥的危險因素分析. 臨床外科雜志, 2017, 25(7): 512-515.
25. 許冰. 食管癌、賁門癌術后心律失常的原因分析. 腫瘤基礎與臨床, 2012, 25(1): 40-42.
26. 郝棟, 劉國魁, 邱新民. 低肺功能食管癌高齡患者的圍術期治療探討. 白求恩軍醫學院學報, 2009, 7(4): 219-220.
27. 沙紀名, 林澤邦, 徐盛松, 等. 臨界肺功能食管癌患者微創手術的臨床療效研究. 安徽醫學, 2019, 40(8): 917-920.
28. Noguchi T, Shichinohe T, Hirano S, et al. Minimally invasive esophagectomy for cancer patients with low pulmonary function. Hepatogastroenterology, 2010, 57(101): 768-771.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Impact of chronic obstructive pulmonary disease on postoperative complications and short-term prognosis in patients undergoing oesophagectomy

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content