Postoperative pulmonary complications and serial pulmonary functions and arterial blood gases in patients undergoing oesophagectomy with or without a thoracotomy

Abstract

Transthoracic (TT) (n = 12) and transhiatal oesophagectomy (THE) (n = 14) were performed in 26 patients (19 males and 7 females) suffering from benign or malignant strictures of oesophagus. Nine of these patients were smokers. Preoperatively, various parameters of pulmonary functions did not differ significantly in two groups of patients. Forced vital capacity (FVC), forced expiratory volume in 1 second FEV1 (L) and forced expiratory flow between 25-75% of vital capacity (FEF 25-75%) showed a decline at second/third, seventh and 6 weeks in the postoperative period compared to preoperative values. Decrease in FVC was significant at all times. The change in FEV1 and FEF25-75% was not statistically significant at 6 weeks. The decrease in arterial oxygen tension (PaO2), maximal breathing capacity (MBC), maximal inspiratory (PImax) and expiratory (PEmax) pressures in the postoperative period was significant at second/third and seventh postoperative days. Three of 26 patients died. Of these two had TT while the third one had THE procedure. Twenty-one patients developed postoperative pulmonary complications (PPCs). Patients who developed PPCs had significantly different MBC, FEF25-75%, PEmax and FEV1 compared to those who did not have PPCs. Long-term studies involving a larger number of patients are required to document changes occurring in pulmonary functions, arterial blood gases and nutritional status of these patients.