Effect of sustained respiratory care until hospital discharge on the incidence of pulmonary complications following esophagectomy for cancer

Abstract

This study assessed the effects of chest physical therapy all through hospital stay until discharge onto the incidence of pulmonary complications in patients having undergone esophagectomy for cancer. Medical records of esophagectomy patients were examined and 40 subsequent ones selected (none excluded), and divided into two groups: one having received chest physiotherapy only in the intensive care unit (ICUg, n=20) and the other having received it during full hospital stay (DISg, n=20). Information concerning pre-, peri- and postoperative periods were drawn from patients' records. Results show that ICUg and DISg were similar (mean±sd) concerning age (55.5±9.9 vs 57.1±10.8 years old), BMI (22.5±3.3 vs 18±4 kg/m²), operating time (400±103.8 vs 408.5±142 min), anesthesia time (498.3±107.3 vs 516±148.9 min) and number of chest physical therapy sessions in the ICU (9.6±14.9 vs 8.3±7.6 sessions). Despite the fact that DISg patients had higher tobacco consumption than ICUg ones (35.7±17.6 vs 26.1±18.4 packs-year, p<0.05), there were 20% less pulmonary complications in this group when compared to the ICU group (10% vs 30%, p<0.05): lesser incidence (75%) of pleural effusion and 50% less of bronchopneumonia. DISg also had undergone a shorter time (less 4.5 days) with pleural drain on (p<0.05). These findings suggest chest physical therapy care all along hospital stay until discharge may reduce pulmonary complications after esophagectomy for cancer.