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Article: Risk analysis in resection of squamous cell carcinoma of the esophagus

TitleRisk analysis in resection of squamous cell carcinoma of the esophagus
Authors
Issue Date1994
PublisherSpringer New York LLC. The Journal's web site is located at http://link.springer.de/link/service/journals/00268/
Citation
World Journal Of Surgery, 1994, v. 18 n. 3, p. 339-346 How to Cite?
AbstractA study of risk factors that affect morbidity and mortality in 523 patients with squamous cell cancer of the esophagus who had one-stage resection was undertaken. The 30-day and hospital mortality rates were 5.0% and 15.5%, respectively. Pulmonary complications, malignant cachexia, and surgical complications accounted for 42%, 25%, and 21% of hospital deaths, respectively. Major pulmonary complications occurred in 23% of patients. Multivariate analysis identified six factors that predicted major pulmonary complications: age, mid-arm circumference, percent of predicted FEV 1, abnormal chest radiograph, amount of blood loss, and palliative resection. Three risk groups of pulmonary complications were identified: low, median, and high risk group with complications in 3%, 17%, and 43% of patients, respectively. Significantly, patients with curative resection had a lower hospital mortality rate (9%) than those with palliative resection (20%), p = 0.001. Patients with stage I, IIa, or IIb disease had a lower hospital mortality rate (9%) than those with stage III or IV disease (18%), p = 0.026. Multivariate analysis identified six factors that predicted hospital death: age, mid-arm circumference, history of smoking, incentive spirometry, number of stairs climbed, and amount of blood loss. Three risk groups of hospital death were identified: low, median, and high risk groups with death in 7%, 30%, and 38%, respectively. Anastomotic leakage rate was 4%. Technical faults were identified in 53% of patients with leakage. Together with other surgical complications, a presumed or apparent technical error was noted in 63% of patients. The identification of high-risk patients and prevention of technical faults can help improve surgical outcome.
Persistent Identifierhttp://hdl.handle.net/10722/83367
ISSN
2015 Impact Factor: 2.523
2015 SCImago Journal Rankings: 1.375
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLaw, SYKen_HK
dc.contributor.authorFok, Men_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2010-09-06T08:40:11Z-
dc.date.available2010-09-06T08:40:11Z-
dc.date.issued1994en_HK
dc.identifier.citationWorld Journal Of Surgery, 1994, v. 18 n. 3, p. 339-346en_HK
dc.identifier.issn0364-2313en_HK
dc.identifier.urihttp://hdl.handle.net/10722/83367-
dc.description.abstractA study of risk factors that affect morbidity and mortality in 523 patients with squamous cell cancer of the esophagus who had one-stage resection was undertaken. The 30-day and hospital mortality rates were 5.0% and 15.5%, respectively. Pulmonary complications, malignant cachexia, and surgical complications accounted for 42%, 25%, and 21% of hospital deaths, respectively. Major pulmonary complications occurred in 23% of patients. Multivariate analysis identified six factors that predicted major pulmonary complications: age, mid-arm circumference, percent of predicted FEV 1, abnormal chest radiograph, amount of blood loss, and palliative resection. Three risk groups of pulmonary complications were identified: low, median, and high risk group with complications in 3%, 17%, and 43% of patients, respectively. Significantly, patients with curative resection had a lower hospital mortality rate (9%) than those with palliative resection (20%), p = 0.001. Patients with stage I, IIa, or IIb disease had a lower hospital mortality rate (9%) than those with stage III or IV disease (18%), p = 0.026. Multivariate analysis identified six factors that predicted hospital death: age, mid-arm circumference, history of smoking, incentive spirometry, number of stairs climbed, and amount of blood loss. Three risk groups of hospital death were identified: low, median, and high risk groups with death in 7%, 30%, and 38%, respectively. Anastomotic leakage rate was 4%. Technical faults were identified in 53% of patients with leakage. Together with other surgical complications, a presumed or apparent technical error was noted in 63% of patients. The identification of high-risk patients and prevention of technical faults can help improve surgical outcome.en_HK
dc.languageengen_HK
dc.publisherSpringer New York LLC. The Journal's web site is located at http://link.springer.de/link/service/journals/00268/en_HK
dc.relation.ispartofWorld Journal of Surgeryen_HK
dc.titleRisk analysis in resection of squamous cell carcinoma of the esophagusen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0364-2313&volume=18&spage=339&epage=346&date=1994&atitle=Risk+analysis+in+resection+of+squamous+cell+carcinoma+of+the+esophagusen_HK
dc.identifier.emailLaw, SYK: slaw@hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authorityLaw, SYK=rp00437en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1007/BF00316812en_HK
dc.identifier.pmid8091773-
dc.identifier.scopuseid_2-s2.0-0028232953en_HK
dc.identifier.hkuros3768en_HK
dc.identifier.volume18en_HK
dc.identifier.issue3en_HK
dc.identifier.spage339en_HK
dc.identifier.epage346en_HK
dc.identifier.isiWOS:A1994NU90300006-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLaw, SYK=7202241293en_HK
dc.identifier.scopusauthoridFok, M=7005879262en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK

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