Factors Affecting Blood Loss During Thoracoscopic Esophagectomy for Esophageal Carcinoma
Background: Major intraoperative hemorrhage reportedly predicts unfavorable survival outcomes following surgical resection for esophageal carcinoma (EC). However, the factors predicting the amount of blood lost during thoracoscopic esophagectomy have yet to be sufficiently studied. We sought to i...
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| Autores principales: | , , , , |
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| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
Korean Society for Thoracic & Cardiovascular Surgery
2021
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| Materias: | |
| Acceso en línea: | https://doaj.org/article/4d7cfebc20394dc7a7f37cb3f7539266 |
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| Sumario: | Background: Major intraoperative hemorrhage reportedly predicts unfavorable survival
outcomes following surgical resection for esophageal carcinoma (EC). However, the factors
predicting the amount of blood lost during thoracoscopic esophagectomy have yet
to be sufficiently studied. We sought to identify risk factors for excessive blood loss during
video-assisted thoracoscopic surgery (VATS) for EC.
Methods: Using simple and multiple linear regression models, we performed retrospective
analyses of the associations between clinicopathological/surgical factors and
estimated hemorrhagic volume in 168 consecutive patients who underwent VATS-type
esophagectomy for EC.
Results: The median blood loss amount was 225 mL (interquartile range, 126–380 mL).
Abdominal laparotomy (p<0.001), thoracic duct resection (p=0.014), and division of the
azygos arch (p<0.001) were significantly related to high volumes of blood loss. Body mass
index and operative duration, as continuous variables, were also correlated positively
with blood loss volume in simple linear regression. The multiple linear regression analysis
identified prolonged operative duration (p<0.001), open laparotomy approach (p=0.003),
azygos arch division (p=0.005), and high body mass index (p=0.014) as independent predictors
of higher hemorrhage amounts during VATS esophagectomy.
Conclusion: As well as body mass index, operation-related factors such as operative duration,
open laparotomy, and division of the azygos arch were independently predictive
of estimated blood loss during VATS esophagectomy for EC. Laparoscopic abdominal procedures
and azygos arch preservation might be minimally invasive options that would
potentially reduce intraoperative hemorrhage, although oncological radicality remains an
important consideration. |
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