Tracheobronchial injury in the setting of an esophagectomy for cancer: Postoperative discovery a bad omen

Research output: Contribution to journalReview article

5 Scopus citations

Abstract

Background A tracheobronchial injury is an uncommon complication of an esophagectomy. Differences in outcomes may exist for patients with injuries detected intraoperatively and postoperatively. Methods A retrospective review was performed for patients who underwent an esophagectomy for cancer at Jackson Memorial Hospital/University of Miami from January 2000 to June 2012. Results An injury to the tracheobronchial tree occurred in 7 of 425 patients (1.6%). The majority of the operations were performed via a transhiatal approach (87.8%). Patients with airway injuries were older (median 73 vs. 63), more likely to have squamous cell carcinoma (85.7% vs. 17.9%), and with proximal tumors (85.7% vs. 14.1%). When given, the type of neoadjuvant treatment consisted of chemoradiotherapy in all patients who suffered an injury, whereas it was only administered to 21.3% of patients without an injury. There were no deaths among three patients in whom the injury was identified intraoperatively. Mortality occurred in three of four patients (75.0%) with an injury detected postoperatively. Conclusions Patients with proximal tumors and radiation administration as a component of neoadjuvant treatment are more likely to suffer a tracheobronchial injury. An aggressive reoperative approach is warranted in patients with injuries that are discovered postoperatively.

Original languageEnglish (US)
Pages (from-to)804-807
Number of pages4
JournalJournal of surgical oncology
Volume109
Issue number8
DOIs
StatePublished - Jun 2014

Keywords

  • major airway
  • malignancy
  • radiation
  • transhiatal

ASJC Scopus subject areas

  • Surgery
  • Oncology

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