Postoperative Complications After Esophagectomy: A Three-Year Single-Center Experience.

Abstract

Background

Esophagectomy is one of the most complex surgical procedures performed for both malignant and selected benign esophageal diseases. Despite improvements in surgical techniques, anesthesia, and perioperative care, esophagectomy remains associated with considerable postoperative morbidity and mortality. Common complications include pulmonary complications, anastomotic leak, wound infection, and cardiac events. Evaluating postoperative complications after esophagectomy is essential to improve perioperative management and patient outcomes.

Objectives

To assess the frequency and pattern of postoperative complications after esophagectomy over a five-year period at a single tertiary care center and to determine their association with hospital stay, intensive care admission, and postoperative mortality.

Methodology

This retrospective descriptive study was conducted at Department of Thoracic Surgery Unit, Lady Reading Hospital  Medical Teaching Institution, Peshawar from jan 2018 to jan 2021. over a three-year period. A total of 100 patients who underwent esophagectomy during the study period were included. Demographic characteristics, indication for surgery, operative duration, type of esophagectomy, postoperative complications, hospital stay, ICU admission, and mortality were recorded using a structured data collection form. Data were analyzed using SPSS version 24. Continuous variables were expressed as mean ± standard deviation, while categorical variables were presented as frequencies and percentages. Statistical significance was set at p < 0.05.

Results

A total of 100 patients underwent esophagectomy during the study period. The mean age of patients was 56.4 ± 11.8 years, and the majority were male (68%). The most common indication for surgery was esophageal carcinoma (84%). Postoperative complications were observed in 42% of patients. The most frequent complication was pulmonary complications (18%), followed by anastomotic leak (10%), surgical site infection (7%), and cardiac complications (5%). Patients who developed complications had a significantly longer hospital stay compared with those without complications (16.2 ± 5.4 days vs 10.1 ± 3.7 days, p = 0.01). ICU admission was required in 20% of patients, while overall postoperative mortality was 6%.

Conclusion

Postoperative complications after esophagectomy remain common and significantly affect hospital stay and patient outcomes. Pulmonary complications and anastomotic leakage were the most frequently observed adverse events. Early identification of high-risk patients and improved perioperative care are essential to reduce morbidity and mortality after esophagectomy