The impact of preoperative oropharyngeal microflora, decontamination, and postoperative nosocomial and opportunistic infections on the occurrence of respiratory complications in patients undergoing esophagectomy for esophageal cancer after chemoradiotherapy. A single-center cohort.

INTRODUCTION

Surgical oesophagectomy remains the primary curative treatment for oesophageal cancer. It is a challenging procedure that carries the possibility of serious postoperative complications. METHODOLOGY: Retrospective analysis of preoperative oropharyngeal microbiologic cultivation, the role of decontamination, and the postoperative microbiologic cultivation in patients after hybrid esophagectomy with mild or severe respiratory complications (pneumonia and respiratory failure), and anastomotic leakage.

RESULTS

Significantly more pneumonias were found in the group without eradication (Escherichia coli, facultative anaerobe, p=0.016) and in the group with new infection (Pseudomonas aeruginosa (hospital-acquired infection, p<0. 0001), Enterobacter cloacae (facultatively anaerobic, p=0.032), E. coli (facultative anaerobes, p<0.0001), Klebsiela pneumoniae (hospital-acquired infection, p<0.0001), Staphylococcus aureus (facultative anaerobe, p=0.0001), Acinetobacter junii (nosocomial infection, p=0.032), and Candida albicans (opportunistic pathogenic yeast, p<0.0001)) p<0.0001. Postoperative positivity for Citrobacter freundi increased the odds of leak by 10.76 times (facultative anaerobic, p=0.042, OR 10.76), and for E. coli by 3.17 times (p=0.017, OR 3.17).

CONCLUSION

Despite the use of targeted antibiotic therapy, a significant proportion of opportunistic and nosocomial infections still occur in the pattern of postoperative respiratory and anastomotic complications in patients after esophagectomy.