Risk analysis in esophageal surgery.

Risk analysis in esophageal surgery. Research Abstract Details 

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Risk analysis in esophageal surgery. Abstract Text:

H Bartels,H J Stein,J R Siewert,

The postoperative mortality after esophagectomy still remains a major factor influencing the prognosis of esophageal cancer and largely depends on the patient's preoperative physiological status. A composite scoring system was developed to predict the risk of esophagectomy, based on quantitative assessment of preoperatively available physiological parameters. The scoring system was reviewed retrospectively on operated patients and evaluated prospectively in two subsequent patient groups. An initial retrospective multivariate analysis of 432 esophagectomy patients identified a compromised general status (p = 0.001) and poor cardiac (p < 0.001), hepatic (p < 0.05), and respiratory (p < 0.05) functions as independent predictors of a fatal postoperative course. Based on the relative risks associated with individual impaired organ functions--general status 3.6, cardiac function 2.8, hepatic function 2.1, pulmonary function 1.7--a composite risk score was established. A prospective study in 121 patients confirmed that this composite scoring system provides better identification of high-risk patients than does any of the individual parameters alone. Including this composite score into the process of patient selection and choice of procedure resulted in a decrease of postoperative mortality from 9.4% (52/553) to 1.2% (4/323) (p = 0.001). The risk of death after esophagectomy for esophageal cancer can be objectively assessed prior to surgery and quantified by a composite risk score. This score provides a useful tool in refining the criteria of patient selection for resection and choice of procedure, and markedly reduces postoperative mortality when applied prospectively.

Risk analysis in esophageal surgery. Publishing Authors By Initials

H Bartels,HJ Stein,JR Siewert,

For similar surgical procedures, operative research abstracts see: surgical procedures, operative research

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Risk analysis in esophageal surgery. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Recent results in cancer research. Fortschritte de

VOLUME: 155

Page Numbers: 89-96

Journal Abbreviation: Recent Results Cancer Res.

ISSN: 0080-0015

DAY: 13

MONTH: 02

YEAR: 2000

Risk analysis in esophageal surgery. Information

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LANGUAGE: eng

NlmUniqueID: 44671

Risk analysis in esophageal surgery. Keywords Mesh Terms:

KEYWORDS: Surgical Procedures, Operative

MESH TERMS: mortality

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Grant and Affiliation Information for Risk analysis in esophageal surgery.

AFFILIATION: Chirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technischen Universität München, Germany.

Country: GERMANY

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MEDLINETA: Recent Results Cancer Res

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