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  • Title: [Respiratory morbidity and mortality following transhiatal esophagectomy in patients with severe chronic obstructive pulmonary disease].
    Author: Marmuse JP, Maillochaud JH.
    Journal: Ann Chir; 1999; 53(1):23-8. PubMed ID: 10083665.
    Abstract:
    In order to assess the influence of severe chronic obstructive pulmonary disease on the pulmonary morbidity and mortality following transhiatal oesophagectomy, the authors reviewed 136 consecutive patients who underwent oesophageal cancer resection by a transhiatal approach. Nineteen patients had a forced expiratory volume in one second (FEV) lower than 60% of the theoretical value, indicating severe chronic obstructive pulmonary disease. The other group of 117 patients had a FEV higher than 60% of the theoretical value. Pulmonary complications occurred in 36 patients: 23 (64%) were minor and 13 (36%) were major. Severe chronic obstructive pulmonary disease did not significantly increase pulmonary morbidity. However, pulmonary complications occurring in this group of patients appeared more severe with a significant increase in major pulmonary complications (21% versus 8%, p = 0.05) and respiratory mortality rates (10% versus 1.6%, p = 0.04). One factor was significantly correlated to respiratory mortality: age higher than 75 years (p = 0.006). Severe chronic obstructive pulmonary disease does not constitute a contraindication for transhiatal oesophagectomy. However, this approach should be reserved for patients under 75 years of age, in order to obtain respiratory morbidity and mortality rates comparable to those of patients with normal spirometry.
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