Relationship between Preoperative Nutritional Support and Postoperative Pulmonary Complications following Esophagectomy for Carcinoma of the Esophagus in Elderly Patients

Nobuaki Sato, Youichi Matsubara, Kazuhiko Manabe, Yoshito Kawashima, Akio Kusama, Haruhiko Makino, Hidenori Ueki, Akira Okawa, Terukazu Muto

First Department of Surgery, Niigata University School of Medicine

The authors attempted to determine whether preoperative nutritional support can reduce the incidence of postoperative pulmonary complications following esophagectomy for carcinoma of the esopagus in elderly patients. Preoperative nutritional parameters, muscle strength, and spirometric function were measured in 151 patients (group I: 45 patients, 70 years of age or older, group II: 106 patients, 33 to 69 years). These patients were followed for postoperative pulmonary complications. The relationship between response to preoperative nutritional support and postoperative pulmonary complications was also examined. There were significant differences in muscle mass, serum albumin level, muscle strength, and spirometric function between group I and group II preoperatively. The incidence of postoperative pulmonary complications in group I was greater than that in group II (p<0.05). Out of 10 patients in group I who received preoperative nutritional support, 7 exhibited weight gain and a decrease in serum albumin. Out of 19 who received nutritional support in group II, 12 exhibited this response. Of the group I patients, 57% (4 out of 7) who showed weight gain and a decrease in serum albumin developed pulmonary complications postoperatively. By contrast, none of the group II patients with this response developed pulmonary complications. On the basis of these results, it is concluded that more efficacious preoperative nutritional support is required for elderly patients with carcinoma of te esophagus to reduce postoperative pulmonary complications.

Key words
elderly patients with carcinoma of the esophagus, nutritional assessment, preoperative nutritional support, postoperative pulmonary complication

Reprint requests
Nobuaki Sato First Department of Surgery, Niigata University School of Medicine
1-757 Asahimachi-dori, Niigata, 951 JAPAN

Accepted
April 11, 1990

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