Browsing by Subject "esophagectomy"

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    Fifteen is just a number
    (Elsevier, 2023-07) Denlinger, Chadrick E.; Surgery, School of Medicine
    Lymph node dissection remains an essential part of any oncologic surgery. At a minimum, sentinel node sampling is required for some cancers. For many solid malignancies, including lung and esophageal cancer, the number of lymph nodes resected correlates with long-term outcomes. The debate remains regarding the relative contributions of the oncologic impact of a thorough lymph node sampling vs stage migration leading to the improved outcomes. An alternative explanation, still, is that a thorough lymph node sampling may just be a surrogate marker of comprehensive quality care, without having any direct impact on cancer-related outcomes.
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    Perioperative Risk Factors for Postoperative Delirium in Patients Undergoing Esophagectomy
    (Elsevier, 2019) Fuchita, Mikita; Khan, Sikandar H.; Perkins, Anthony J.; Gao, Sujuan; Wang, Sophia; Kesler, Kenneth A.; Khan, Babar A.; Anesthesia, School of Medicine
    Background Postoperative delirium affects up to 50% of patients undergoing esophagectomy and is associated with negative outcomes. The perioperative risk factors for delirium in this population are not well understood. We conducted this study to assess perioperative risk factors for postoperative delirium among esophagectomy patients. Methods We performed a secondary data analysis of patients enrolled in a randomized controlled trial evaluating the efficacy of haloperidol prophylaxis postoperatively in reducing delirium among esophagectomy patients. Postoperative delirium was assessed twice daily using the Confusion Assessment Method for the ICU. Univariate and logistic regression analyses were performed to examine the association between perioperative variables and development of postoperative delirium. Results Of 84 consecutive esophagectomy patients, 27 (32%) developed postoperative delirium. Patients who developed postoperative delirium had higher APACHE II scores [22.1 (6.5) versus 17.4 (6.8); p=0.003], longer mechanical ventilation days [1.7 (1.4) versus 1.0 (1.1); p=0.001], and longer ICU days [5.1 (2.6) versus 2.6 (1.6); p<0.001]. In a logistic regression model, only ICU length of stay was found to have significant association with postoperative delirium [OR 1.65; 95% CI 1.21-2.25]. Conclusions ICU length of stay was significantly associated with postoperative delirium. Other perioperative factors including duration of surgery, blood loss, and hemoglobin levels were not significantly associated with postoperative delirium.