Predictive factors for postoperative tachyarrhythmia after thoracoscopic esophagectomy and the usefulness of landiolol hydrochloride for its treatment

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• 作者：Koichi Okamoto (1)
  Itasu Ninomiya (1)
  Shogo Maruzen (1)
  Hiroto Saito (1)
  Tomoya Tsukada (1)
  Jun Kinoshita (1)
  Isamu Makino (1)
  Keishi Nakamura (1)
  Katsunobu Oyama (1)
  Tomoharu Miyashita (1)
  Hidehiro Tajima (1)
  Hiroyuki Takamura (1)
  Hirohisa Kitagawa (1)
  Sachio Fushida (1)
  Takashi Fujimura (1)
  Tetsuo Ohta (1)
  
• 关键词：Esophageal neoplasm ; Tachycardia ; Thoracoscopy ; Esophagectomy ; Landiolol
• 刊名：Esophagus
• 出版年：2014
• 出版时间：April 2014
• 年：2014
• 卷：11
• 期：2
• 页码：89-98
• 全文大小：472 KB
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• 作者单位：Koichi Okamoto (1)
  Itasu Ninomiya (1)
  Shogo Maruzen (1)
  Hiroto Saito (1)
  Tomoya Tsukada (1)
  Jun Kinoshita (1)
  Isamu Makino (1)
  Keishi Nakamura (1)
  Katsunobu Oyama (1)
  Tomoharu Miyashita (1)
  Hidehiro Tajima (1)
  Hiroyuki Takamura (1)
  Hirohisa Kitagawa (1)
  Sachio Fushida (1)
  Takashi Fujimura (1)
  Tetsuo Ohta (1)
  
  1. Division of Cancer Medicine, Gastroenterologic Surgery, Department of Oncology, Graduate School of Medical Science, Kanazawa University, 13-1 Takara-Machi, Kanazawa, Ishikawa, 920-8641, Japan
  
• ISSN：1612-9067

文摘

Background Tachyarrhythmia after esophagectomy is a severe complication that should not be underestimated because of its negative impact. The aims of this study were to clarify the cause and impact of postoperative tachyarrhythmia after thoracoscopic esophagectomy. Additionally, we analyzed the usefulness of landiolol administration for postoperative tachyarrhythmia. Methods We evaluated the predictive factors for tachyarrhythmia onset after surgery and its clinical impact in 127 patients who underwent thoracoscopic esophagectomy with extended lymphadenectomy. Moreover, we analyzed the efficacy of landiolol for postoperative tachyarrhythmia. Results Tachyarrhythmia developed in 38 of the 127 patients. Multivariate analysis showed that advanced age, heart disease, and hyperlipidemia were associated with postoperative tachyarrhythmia. Hyponatremia, hypoalbuminemia, and leukocytosis on postoperative day 3 were significantly associated with tachyarrhythmia onset. The incidence of all complications and respiratory complications, including pneumonia, was significantly higher in patients with than in those without tachyarrhythmia. The mortality rate in the tachyarrhythmia group tended to be higher than that in the nontachyarrhythmia group. Landiolol as a treatment for tachyarrhythmia immediately decreased heart rate and safely reduced subsequent respiratory complications. Conclusion In elderly patients with cardiac disease or hyperlipidemia, surgeons should be alert for the occurrence of tachyarrhythmia after esophagectomy. Postoperative tachyarrhythmia is a marker of morbidities with particular emphasis on respiratory complications. However, it can be adequately managed by landiolol, resulting in fewer respiratory complications. Landiolol might be a safe and convenient agent for managing postoperative tachyarrhythmia after thoracoscopic esophagectomy, resulting in lower mortality and morbidity rates.