RELATIONSHIP BETWEEN PREOPERATIVE ASSESSMENT OF ORGAN FUNCTION AND POSTOPERATIVE MORBIDITY IN PATIENTS WITH ESOPHAGEAL CANCER

Objective: To find out if strict assessment of organ function preopera tively predicted morbidity and mortality in patients being operated on for oesophageal carcinoma. Design: Retrospective study. Setting: Teac hing hospital, Japan. Subjects: 178 patients operated on for oesophage al cancer 1989-1993. Interventions: Oesophagectomy and reconstruction (using either stomach or colon) in one stage by a right thracoabdomina l approach in 173, and transhiatal resection in 5 with either poor pul monary reserve or early lesions. Main outcome measures: Correlation be tween preoperative assessment of organ function and postoperative deve lopment of complications. Result: 79 patients (44%) developed complica tions and 6 died (3%). Pulmonary dysfunction preoperatively was signif icantly associated with the development of all complications (p = 0.00 1) and of postoperative pulmonary complications (p = 0.04). No other p reoperative assessment correlated significantly with the development o f postoperative complications. Conclusion: Accurate preoperative asses sment of pulmonary function is a valuable indicator of postoperative m orbidity.