Discussion
respiratory complications, respiratory complication, expectoration
ESOPHAGEAL CANCER, POSTOPERATIVE COMPLICATIONS, COMPLICATIONS, RESPIRATORY COMPLICATIONS, RESPIRATORY COMPLICATION
The minimally invasive approach to thoracoscopic and laparoscopic esophagectomy has been applied for patients with esophageal cancer. The successful management of respiratory secretion can decrease postoperative complications and improve patient outcomes. The present study performed early fiberoptic bronchoscopic sputum aspiration and lavage after thoracoscopic and laparoscopic esophagectomy. The present study results revealed that patients had a shorter length of hospital stay, and lower medical expenses and incidences of postoperative complications. Early fiberoptic bronchoscopic sputum aspiration and lavage can be used after thoracoscopic and laparoscopic esophagectomy to improve patient outcomes.For patients with esophageal cancer, thoracoscopic and laparoscopic radical esophagectomy can preserve the latissimus dorsi and intercostal muscles, in order to maintain respiratory function and facilitate postoperative recovery [The traditional postoperative care to facilitate sputum expectoration include oral or nasal suction, nebulizer treatment, breathing exercise, back clapping, and corticosteroid administration [In the present study, patients in the study group had a shorter length of hospital stay, when compared to patients in the control group. Furthermore, patients in the study group incurred lower medical expenses. All these were attributed to the successful sputum removal and pulmonary lavage through the early fiberoptic bronchoscopic procedure. In addition, antibiotics were locally injected for these patients to reach a high topic concentration of antibiotics in the pulmonary tissues. All these can shorten the length of hospital stay and reduce medical expenses, ultimately improving patient outcomes.The incidence of postoperative complications was also investigated in the present study. The results revealed that the incidence of overall complications was 45.2% and the incidence of respiratory complications was 28.3% in the control group. The respiratory complication was lower than that reported by a previous study (40% respiratory complication) [The limitations of the present study include the single-center nature of the study, and the small sample size. Furthermore, the performance of the fiberoptic bronchoscopy and sputum removal was influenced by the skill of the operator. The present study results need to be confirmed through future large-scale studies.