[Serious postoperative complications after esophagectomy for esophageal carcinoma: analysis of risk factors]

To identify risk factors for postoperative morbidity and mortality in patients undergoing esophagectomy for esophageal cancer.

The population comprised 159 patients with locally advanced esophageal cancer, undergoing esophagectomy between January 1985 and December 2004.

Infections were the main cause of both complications and postoperative mortality. The 54% of our patients presented serious complications. The mortality of the series was 12.5%. Multiorganic failure secondary to sepsis was the more frequent cause of death. The postoperative complications showed a significant association with: alcoholism (p < 0.04), hepatic cirrhosis (p < 0.03), the location of the tumor in middle third of the esophagus (p < 0.04), and the APACHE II score greater of 10 (p < 0.003). Mortality was associated significantly with the presence of chronic pulmonary disease (p = 0,03) and with an APACHE II score superior to 10 (p = 0,02).

The APACHE II score superior to 10 can be used so much as prognostic factor of mortality like of serious complications. Chronic obstructive pulmonary disease is a risk factor for postoperative mortality. Alcoholism, hepatic cirrhosis and the location of the tumor, are factors associated to postoperative serious complications.