Aspiration Pneumonia after Esophagectomy

Yuji Tachimori, Hiroshi Watanabe, Hoichi Kato

Department of Surgery, National Cancer Center Hospital

Out of 297 patients who underwent esophagectomy for thoracic esophageal cancer, 19 (6%) developed postoperative pneumonia. In 15 patients, aspiration, including silent aspiration, was the cause of pneumonia, and 11 had recurrent laryngeal nerve paralysis. For preventing pneumonia after esophagectomy, intrabronchial suction by means of a fiberscope was routinely performed for postoperative care. A minitracheostomy tube was inserted through the cricothyroid membrane in 13 patients for intrabronchial suction. Only one of the 10 patients in whom the tube was inserted within 14 days after esophagectomy developed pneumonia. Recently, injection for vocal fold paralysis by means of a flexible fiberscope was newly developed and performed in 16 patients. In 5 patients, it was performed within 7 days after esophagectomy. Intrabronchial suction by means of a fiberscope, minitracheostomy tube through the cricothyroid membrane and injection for vocal fold paralysis by means of a flexible fiberscope were useful for the prevention of postoperative pneuminia after esophagectomy.

Key words
esophageal cancer operation, aspiration pneumonia, postesophagectomy recurrent laryngeal nerve paralysis, intrafold injection of vocal cord

Reprint requests
Yuji Tachimori Department of Surgery, National Cancer Center Hospital
5-1-1 Tsukiji, Chuo-ku, Tokyo, l04 JAPAN

Accepted
December 13, 1989

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