Esophageal Resection Complications Linked To Longer Surgeries, Blood Loss: Study

Almost one-in-five patients who undergo an esophagectomy are readmitted to the hospital due to complications, mostly involving respiratory and gastrointestinal problems that may occur more frequently during prolonged surgeries or procedures where patients lose a lot of blood, according to the findings of a new study. 

Researchers with the Mayo Clinic report that nearly 19% of patients experience espohageal resection complications that send them back to the hospital within a month, often due to problems that are avoidable. The findings were presented last week at the annual meeting of the American Association for Thoracic Surgery, but have not yet been published for peer review.

Esophagectomies are surgical procedures where part of the esophagus is removed to treat esophageal cancer. The remaining sections are then reattached in hopes that all the cancer has been removed before it spread to other areas. However, the procedure is known to have a high readmission rate and complications are common.

Mayo Clinic researchers looked at readmission rates for more than one year at a high-volume center, following the outcomes over a 30 day period for 84 patients.

The findings indicate that 19% of patients who undergo the procedure are readmitted due to complications, with the most common factors being respiratory and gastrointestinal problems. They also found a number of risk factors that appeared to increase the likelihood of readmissions, including longer operations, postoperative admission to the Intensive Care Unit, and blood transfusions around the time of the surgery.

“These findings will allow surgeons to identify frail patients using preoperative scoring systems to try to ensure that patients are as healthy as possible before surgery and reduce the likelihood of ICU stay,” Dr. Stephen D. Cassivi, senior investigator of the study, said in the press release. “Complicated surgery may be associated with more blood loss, and, therefore, should be carefully planned and carried out.”

The study found that there was little difference in whether the facility where the procedure took place was a high-volume center, meaning that its surgeons had more experience with the procedure.

Researchers said they conducted the study both because complications and unplanned readmissions could negatively affect patients’ quality of life and recovery, and because the U.S. Centers for Medicaid and Medicare Services could reduce reimbursement payments to hospitals that show high rates of readmission.