Impact of postoperative morbidity on long-term survival after oesophagectomy

Hii, M. W., Smithers, B. M., Gotley, D. C., Thomas, J. M., Thomson, I., Martin, I. and Barbour, A. P. (2013) Impact of postoperative morbidity on long-term survival after oesophagectomy. British Journal of Surgery, 100 1: 95-104. doi:10.1002/bjs.8973

Author Hii, M. W.
Smithers, B. M.
Gotley, D. C.
Thomas, J. M.
Thomson, I.
Martin, I.
Barbour, A. P.
Title Impact of postoperative morbidity on long-term survival after oesophagectomy
Journal name British Journal of Surgery   Check publisher's open access policy
ISSN 0007-1323
Publication date 2013-01
Year available 2012
Sub-type Article (original research)
DOI 10.1002/bjs.8973
Open Access Status DOI
Volume 100
Issue 1
Start page 95
End page 104
Total pages 10
Place of publication Chichester, West Sussex, United Kingdom
Publisher John Wiley & Sons
Collection year 2013
Language eng
Formatted abstract
Background: Oesophageal malignancy is a disease with a poor prognosis. Oesophagectomy is the mainstay of curative treatment but associated with substantial morbidity and mortality. Although mortality rates have improved, the incidence of perioperative morbidity remains high. This study assessed the impact of postoperative morbidity on long-term outcomes.

Methods: A prospective database was designed for patients undergoing oesophagectomy for malignancy from 1998 to 2011. An observational cohort study was performed with these data, assessing intraoperative technical complications, postoperative morbidity and effects on overall survival.

Results: Some 618 patients were included, with a median follow-up of 51 months for survivors. The overall complication rate was 64·6 per cent (399 of 618), with technical complications in 124 patients (20·1 per cent) and medical complications in 339 (54·9 per cent). Technical complications were associated with longer duration of surgery (308 min versus 293 min in those with no technical complications; P = 0·017), greater operative blood loss (448 versus 389 ml respectively; P = 0·035) and longer length of stay (22 versus 13 days; P < 0·001). Medical complications were associated with greater intraoperative blood loss (418 ml versus 380 ml in those with no medical complications; P = 0·013) and greater length of stay (16 versus 12 days respectively; P < 0·001). Median overall and disease-free survival were 41 and 43 months. After controlling for age, tumour stage, resection margin, length of tumour, adjuvant therapy, procedure type and co-morbidities, there was no effect of postoperative complications on disease-specific survival.

Conclusion: Technical and medical complications following oesophagectomy were associated with greater intraoperative blood loss and a longer duration of inpatient stay, but did not predict disease-specific survival.
Keyword Oesophageal malignancy
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Article first published online: 12 November 2012.

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
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