Study protocol
bradycardia, bacterial infection, diabetes, alcohol abuse, hypotension, COPD, flushing
ESOPHAGEAL CANCER, BACTERIAL INFECTION, PULMONARY INFECTION, CHRONIC OBSTRUCTIVE PULMONARY DISEASE, COPD, CAVITY, DIABETES
The baseline characteristics, including the demographics, history of smoking, alcohol abuse, diabetes, chronic obstructive pulmonary disease (COPD), neoadjuvant therapy, and location and stage of the esophageal cancer, were recorded. The patients were randomized to the control and study groups using the random ball method. After the thoracoscopic and laparoscopic esophagectomy, patients in the control group received traditional treatment, while patients in the study group received fiberoptic bronchoscopic lavage and sputum aspiration, in addition to traditional treatment.The thoracoscopic and laparoscopic esophagectomy was performed according to the standard method [The fiberoptic bronchoscopic sputum aspiration and lavage was performed according to the following steps: (1) the fiberoptic bronchoscope, adequate light source system, negative pressure suction, oxygen saturation monitor, oxygen supply, and cardiac monitor were prepared in advance; (2) the patient was laid flat, and high-flow oxygen (6–8 L/min) was provided for 20 min before the procedure; (3) the nasal cavity was cleaned, and topical 2% lidocaine was applied for local anesthesia; (4) a fiberoptic bronchoscope was inserted through one nostril, and high-flow oxygen was provided through the other nostril to maintain an oxygen saturation of > 90% throughout the procedure; (5) a bronchoscope was entered into the left and right bronchus, respectively, and the sputum was aspirated with a constant negative pressure of 150 mmHg (if the patient had thick sputum, 10–20 ml of saline was used for repeated flushing and aspiration, and the lavage fluid was sent for culture and sensitivity analysis; if there was a laboratory positive result for confirmed bacterial infection and pulmonary infection, alveolar lavage was performed with the relevant sensitive antibiotics); (6) the fiberoptic bronchoscope was withdrawn. The whole procedure was performed for approximately 15 min. The procedure was terminated when the patient had bradycardia, hypotension, or an oxygen saturation of < 85%.