Pulmonary complications in patients with chronic obstructive pulmonary disease following transthoracic esophagectomy

Table 1 Baseline characteristics of study population with or without COPD undergoing transthoracic esophagectomy

Characteristics	COPD(n = 86, %)	Non-COPD(n = 272, %)	P value
Age, yr	61.3 ± 5.5	63.2 ± 7.1	0.522
Sex (male:female)	63/23	191/81	0.638
Smoking history	79 (91.9)	214 (78.7)	< 0.01
Past medical history
Hypertension	16 (18.6)	48 (17.6)	0.840
Cardiac disease	13 (15.1)	35 (12.9)	0.594
Diabetes	10 (11.6)	33 (12.1)	0.900
Cancer stage
I	17 (19.8)	56 (20.6)	0.869
II	48 (55.8)	145 (53.3)	0.685
III	21 ( 24.4)	71 (26.1)	0.115
IV	0	0	-
Site of anastomosis
Neck	32 (37.2)	108 (39.7)	0.679
Chest	54 (62.8)	164 (60.3)	0.679
Duration of operation (min)	162.75 ± 51.05	185.15 ± 66.24	0.239
Blood loss (mL)	365.50 ± 219.36	434.00 ± 232.48	0.344
Low serum albumin (< 35g/L)	25 (29.1)	89 (32.7)	0.526
Spirometry
FEV1 (L)	1.6 ± 0.3	2.3 ± 0.5	< 0.01
FEV1,% predicted	51.5 ± 10.5	80.4 ± 13.1	< 0.01
FEV1/FVC,%	57.6 ± 8.9	73.3 ± 6.8	< 0.01
DLCO,% predicted	83.7 ± 13.4	85.0 ± 13.9	0.774

FEV1 = forced expiratory volume in 1 s; FVC = forced vital capacity; DLCO = diffusion capacity of the lung for carbon monoxide.

Table 2 Pulmonary complications occurring in patients with or without COPD undergoing transthoracic esophagectomy

Pulmonary complications	COPD(n = 86)	Non-COPD(n = 272)	P value
Pneumonia	15	19	< 0.01
Atelectasis	13	15	< 0.01
Pulmonary abscess	4	5	0.227
Prolonged O2 supplement	10	11	< 0.01
Prolonged mechanical ventilation	8	10	< 0.05
Acute respiratory distress syndrome	5	4	< 0.05

Table 3 Degree of COPD and outcomes in patients with or without POPC in COPD group

Severity of COPD	POPCs (n = 29)	Non-POPCs (n = 57)	P value
FEV1,%predicted
GradeI(> 80%)	10	35	< 0.05
GradeIIA (50%-80%)	13	19
GradeIIB (30%-50%)	6	3
GradeIII (< 30%)	0	0

POPCs = postoperative pulmonary complications.

Table 4 Comparison of PaO₂ changes in the first postoperative week in patients with or without POPCs in COPD group (mean±SD)

Time	POPCs	Non-POPCs	P
1 preoperative day	82.17 ± 7.37	82.75 ± 4.45	0.758
1 postoperative day	68.38 ± 5.24	76.00 ± 8.28	< 0.01
2 postoperative day	61.83 ± 7.03	69.05 ± 7.78	< 0.01
3 postoperative day	61.75 ± 6.14	67.20 ± 7.35	< 0.05
4 postoperative day	62.71 ± 4.93	70.15 ± 9.34	< 0.01
5 postoperative day	61.13 ± 5.62	72.75 ± 10.30	< 0.001
6 postoperative day	61.83 ± 6.49	76.55 ± 9.62	< 0.001
7 postoperative day	61.63 ± 6.31	80.45 ± 7.50	< 0.001

PaO₂= partial pressure of oxygen.

Table 5 Comparison of PaCO₂ changes in the first postoperative week in patients with or without POPCs in COPD group (mean ± SD)

Time	POPCs	Non-POPCs	P
`1 preoperative day	42.85 ± 4.10	42.37 ± 6.03	0.766
1 postoperative day	44.42 ± 4.61	41.24 ± 4.93	< 0.05
2 postoperative day	45.35 ± 4.97	41.38 ± 5.19	< 0.05
3 postoperative day	46.02 ± 4.88	42.45 ± 5.62	< 0.05
4 postoperative day	46.01 ± 5.56	39.10 ± 3.59	< 0.001
5 postoperative day	44.63 ± 5.31	40.62 ± 5.44	< 0.05
6 postoperative day	45.95 ± 6.56	42.03 ± 5.60	< 0.05
7 postoperative day	45.18 ± 5.80	40.49 ± 6.13	< 0.05

PaCO₂= partial pressure of carbon dioxide.

Table 6 Comparison of SaO₂ changes in the first postoperative week in patients with or without POPCs in COPD group (mean±SD)

Time	POPCs	Non-POPCs	P
1 preoperative day	94.48 ± 1.93	94.44 ± 1.51	0.940
1 postoperative day	94.56 ± 1.18	93.78 ± 1.80	0.095
2 postoperative day	94.01 ± 1.94	94.30 ± 1.39	0.572
3 postoperative day	95.39 ± 1.15	94.56 ± 1.75	0.077
4 postoperative day	94.65 ± 1.27	95.31 ± 1.15	0.079
5 postoperative day	94.94 ± 1.39	94.26 ± 1.81	0.176
6 postoperative day	94.88 ± 1.60	94.96 ± 1.74	0.868
7 postoperative day	95.02 ± 1.16	94.61 ± 1.90	0.399

SaO₂= arterial oxygen saturation.