Perioperative Factors Associated with Tracheostomy use following Esophagectomy Surgery

Gerstman Michelle,Mohammed Kabir,Hacking Matthew,Friedlaender Gemma,Wigmore Timothy,Batty John

doi:10.36959/377/352

Abstract

Esophagectomy surgery remains high risk with 36% of patients in the UK having a complication. Tracheostomy insertion can aid weaning from ventilation post-operatively and can be inserted at the time of surgery (elective) or post-operatively (delayed). We aimed to identify factors associated with elective and delayed tracheostomies, as well as differences in outcomes in each group.

Highlights

Esophagectomy is a major oncological surgical procedure, associated with significant morbidity and mortality [1,2]
Elective tracheostomy insertion at the completion of the esophagectomy is considered in our institution
There were no differences in age or gender, tumor staging, neoadjuvant chemotherapy, pulmonary function (FEV1), forced vital capacity (FVC), max work performed on cardiopulmonary exercise testing (CPET), laparoscopic assisted versus open technique, intraoperative fluid given or blood loss between the groups

Summary

Introduction

Esophagectomy is a major oncological surgical procedure, associated with significant morbidity and mortality [1,2]. After esophagectomy, where feasible at our institution we aim to extubate on the day of surgery. In certain cases, such as patients with difficulty with oxygenation intraoperatively, complicated and prolonged surgery, severe lung disease or high inotrope requirements, it is not possible to extubate on the day of surgery [3,4,5]. In these cases, elective tracheostomy insertion at the completion of the esophagectomy is considered in our institution. Esophagectomy surgery remains high risk with 36% of patients in the UK having a complication. We aimed to identify factors associated with elective and delayed tracheostomies, as well as differences in outcomes in each group

Objectives

Methods

Results

Discussion

Conclusion