Objective: To find out if strict assessment of organ function preoperatively predicted morbidity and mortality in patients being operated on for oesophageal carcinoma.
Design: Retrospective study.
Setting: Teaching hospital, Japan.
Subjects: 178 patients operated on for oesophageal cancer 1989-1993.
Interventions: Oesophagectomy and reconstruction (using either stomach or colon) in one stage by a right thoracoabdominal approach in 173, and transhiatal resection in 5 with either poor pulmonary reserve or early lesions.
Main outcome measures: Correlation between preoperative assessment of organ function and postoperative development of complications.
Result: 79 patients (44%) developed complications and 6 died (3%). Pulmonary dysfunction preoperatively was significantly associated with the development of all complications (p=0.001) and of postoperative pulmonary complications (p=0.04). No other preoperative assessment correlated significantly with the development of postoperative complications.
Conclusion: Accurate preoperative assessment of pulmonary function is a valuable indicator of postoperative morbidity.