Relationship between preoperative assessment of organ function and postoperative morbidity in patients with oesophageal cancer.

OBJECTIVE

To find out if strict assessment of organ function preoperatively predicted morbidity and mortality in patients being operated on for oesophageal carcinoma.

DESIGN

Retrospective study.

SETTING

Teaching hospital, Japan.

SUBJECTS

178 patients operated on for oesophageal cancer 1989-1993.

INTERVENTIONS

Oesophagectomy and reconstruction (using either stomach or colon) in one stage by a right thoracoabdominal approach in 173, and transhiatal resection in 5 with either poor pulmonary reserve or early lesions.

MAIN OUTCOME MEASURES

Correlation between preoperative assessment of organ function and postoperative development of complications.

RESULT

79 patients (44%) developed complications and 6 died (3%). Pulmonary dysfunction preoperatively was significantly associated with the development of all complications (p=0.001) and of postoperative pulmonary complications (p=0.04). No other preoperative assessment correlated significantly with the development of postoperative complications.

CONCLUSION

Accurate preoperative assessment of pulmonary function is a valuable indicator of postoperative morbidity.