ASA score as prognostic criterion for incidence of postoperative complications after transhiatal esophagectomy

The aim of this study is to point out the importance of the American Society of Anesthesiologists risk score (ASA score) as a very cheap and simple prognostic criterion for the incidence and severity of postoperative complications of transhiatal esophagectomy (THE). During the past ten years, twenty-nine patients were operated for cancer of the esophagus using the THE method at the University Hospital Center "Rijeka". Patients' preoperative physical status was estimated using the 19 parameters of ASA score and they were classified into ASA risk groups. The incidence and severity of the two most common and potentially fatal postoperative complications of THE--aspiration pneumonia and anastomotic leak--were compared with the patients ASA score as well as with the duration of postoperative hospital stay and operative mortality. Postoperative complications after THE, even with lethal outcome occurred only in patients with high ASA score (ASA risk group IV and V). Our conclusion is that ASA score has proven to be a reliable and useful prognostic criterion for the development of postoperative complications after THE and for the incidence of operative mortality.