Bronchial Aspiration after Resection of Intrathoracic Esophageal Cencer

Hajime Yonekawa, Shingo Shima, Masayuki Gotoh, Yoshiaki Sugiura, Yutaka Yoshizumi, Susumu Tanaka

Department of Surgery II, National Defense Medical College

Between 1983 and 1987, postoperative bronchial aspiration was studied in 54 patients with intrathoracic esophageal cancer who underwent tumor resection by right thoracotomy. 1) Postoperative bronchial aspiration occured in 38.9%. 2) The age, gender of the patients, and the stage of the cancer were not significantly correlated with postoperative aspiration. 3) The frequency of postoperative aspiration increased from 11.5% in 1983 and 84 to 64.3% in 1985 through 87. During the same period, lymphnode dissection in the upper mediastinum became more aggressive; the average number of the resected nodes in the upper mediastinum per each patinet tripled. 4) Aspiration occurred most frequently in patients who received esophago-gastrostomy via the subcutaneous route followed by those via the retrosternal and posterior mediastinal routes. 5) There was a close correlation among lymphnode dissection in the upper mediastinum, recurrent nerve palsy, and postoperative aspiration, however postoperative adhesion and sensory disturbance of the pharynx may also promote the aspiration.

Key words
carcinoma of the esophagus, postoperative bronchial aspiration, recurrent nerve palsy

Reprint requests
Hajime Yonekawa Department of Surgery II, National Defense Medical Collge
3-2 Namiki, Tokorozawa, 359 JAPAN

Accepted
February 14, 1990

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