Evaluation of the feasibility and safety of immediate extubation after esophagectomy with extended radical three-field lymph node dissection for thoracic esophageal cancers

摘要

Background. No standard procedure exists in respiratory management, including mechanical ventilation, which is commonly administered, after thoracic esophagectomy for esophageal cancer.Methods. Various perioperative clinical parameters and complications were retrospectively compared between the patients who underwent mechanical ventilation (MV group, n = 38) and those who were extubated immediately (immediate extubation: IE group, n = 75), following transthoracic esophagectomy with three-field lymph node dissection (3FLND) for thoracic esophageal cancers. Results. There were no significant differences between the two groups in the early postoperative clinical course. The frequencies of postoperative complications were 39% and 47% in the IE and MV groups, respectively, and pulmonary complications tended to occur more frequently in the MV group (23.7%) than in the IE group (12.0%). Mobilization of the patients was significantly earlier in the IE group than in the MV group (P < 0.0001).Conclusions. IE is feasible and safe even after transthoracic esophagectomy with 3FLND. To avoid the possible disadvantages of MV after surgery, IE can be a standard protocol for postoperative management after transthoracic esophagectomy with radical lymph node dissection.