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:	Masayuki Urabe, Yu Ohkura, Shusuke Haruta, Masaki Ueno, Harushi Udagawa
Formato:	article
Lenguaje:	EN
Publicado:	Korean Society for Thoracic & Cardiovascular Surgery 2021
Materias:	azygos arch blood volume esophageal neoplasms esophageal surgery thoracoscopy Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/4d7cfebc20394dc7a7f37cb3f7539266
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spelling	oai:doaj.org-article:4d7cfebc20394dc7a7f37cb3f75392662021-12-03T01:23:42ZFactors Affecting Blood Loss During Thoracoscopic Esophagectomy for Esophageal Carcinoma10.5090/jcs.21.0472765-16062765-1614https://doaj.org/article/4d7cfebc20394dc7a7f37cb3f75392662021-12-01T00:00:00Zhttps://doaj.org/toc/2765-1606https://doaj.org/toc/2765-1614Background: 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.Masayuki UrabeYu OhkuraShusuke HarutaMasaki UenoHarushi UdagawaKorean Society for Thoracic & Cardiovascular Surgeryarticleazygos archblood volumeesophageal neoplasmsesophageal surgerythoracoscopyMedicine (General)R5-920ENJournal of Chest Surgery, Vol 54, Iss 6, Pp 446-472 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	azygos arch blood volume esophageal neoplasms esophageal surgery thoracoscopy Medicine (General) R5-920
spellingShingle	azygos arch blood volume esophageal neoplasms esophageal surgery thoracoscopy Medicine (General) R5-920 Masayuki Urabe Yu Ohkura Shusuke Haruta Masaki Ueno Harushi Udagawa Factors Affecting Blood Loss During Thoracoscopic Esophagectomy for Esophageal Carcinoma
description	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.
format	article
author	Masayuki Urabe Yu Ohkura Shusuke Haruta Masaki Ueno Harushi Udagawa
author_facet	Masayuki Urabe Yu Ohkura Shusuke Haruta Masaki Ueno Harushi Udagawa
author_sort	Masayuki Urabe
title	Factors Affecting Blood Loss During Thoracoscopic Esophagectomy for Esophageal Carcinoma
title_short	Factors Affecting Blood Loss During Thoracoscopic Esophagectomy for Esophageal Carcinoma
title_full	Factors Affecting Blood Loss During Thoracoscopic Esophagectomy for Esophageal Carcinoma
title_fullStr	Factors Affecting Blood Loss During Thoracoscopic Esophagectomy for Esophageal Carcinoma
title_full_unstemmed	Factors Affecting Blood Loss During Thoracoscopic Esophagectomy for Esophageal Carcinoma
title_sort	factors affecting blood loss during thoracoscopic esophagectomy for esophageal carcinoma
publisher	Korean Society for Thoracic & Cardiovascular Surgery
publishDate	2021
url	https://doaj.org/article/4d7cfebc20394dc7a7f37cb3f7539266
work_keys_str_mv	AT masayukiurabe factorsaffectingbloodlossduringthoracoscopicesophagectomyforesophagealcarcinoma AT yuohkura factorsaffectingbloodlossduringthoracoscopicesophagectomyforesophagealcarcinoma AT shusukeharuta factorsaffectingbloodlossduringthoracoscopicesophagectomyforesophagealcarcinoma AT masakiueno factorsaffectingbloodlossduringthoracoscopicesophagectomyforesophagealcarcinoma AT harushiudagawa factorsaffectingbloodlossduringthoracoscopicesophagectomyforesophagealcarcinoma
_version_	1718373985433944064

Factors Affecting Blood Loss During Thoracoscopic Esophagectomy for Esophageal Carcinoma

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