Miyamoto Keiichi, Koizumi Hiroyuki, Shiobara Hiroyuki, Kawasaki Hitoshi, Wajima Naoki, Maruyama Masaki, Takahashi Kentaro, Kubo Norihito, Hakamada Kenichi
Dept. of Gastroenterological Surgery, Hirosaki University.
Gan To Kagaku Ryoho. 2011 Nov;38(12):1933-5.
We examined factors contributing to an onset of postoperative pulmonary complications following esophagectomy for esophagus cancer. One hundred thirty-two cases of the resected esophageal cancer were studied. We considered the relationship between preoperative patient factors, operative factors, clinical stage factors and postoperative pulmonary complications. Postoperative pulmonary complication was observed in 27 cases (20%). The incidence of postoperative pulmonary complications was significantly higher in patients aged 70 and above and those with a preoperative serum albumin value of less than 4 .0 g/dL. Additionally, these two factors were correlated with an onset of postoperative pulmonary complications in multivariate analyses. A decrease of preoperative serum albumin value was reflecting the chronic poor nutritional condition. Moreover, it was possible that poor nutritional condition served as a prognostic factor of postoperative complications in relation to reduction of cellular immunity. The results indicated that there was a possibility of decreasing an onset of postoperative pulmonary complications using various nutrition managements before operations.
我们研究了食管癌食管切除术后发生肺部并发症的相关因素。对132例食管癌切除病例进行了研究。我们探讨了术前患者因素、手术因素、临床分期因素与术后肺部并发症之间的关系。27例(20%)患者出现术后肺部并发症。70岁及以上患者以及术前血清白蛋白值低于4.0 g/dL的患者术后肺部并发症的发生率显著更高。此外,在多因素分析中,这两个因素与术后肺部并发症的发生相关。术前血清白蛋白值降低反映了慢性营养状况不佳。此外,营养状况不佳可能作为术后并发症的预后因素与细胞免疫降低有关。结果表明,术前采用各种营养管理措施有可能降低术后肺部并发症的发生率。