Fallo de rescate tras una esofagectomía. La importancia de registrar las complicaciones. Estudio retrospectivo a lo largo de 20 años

IF 1.5 4区医学 Q3 SURGERY

Cirugia Espanola Pub Date : 2026-09-01 Epub Date: 2026-09-16 DOI:10.1016/j.ciresp.2026.800376

Silvia Carbonell-Morote, Miriam Menéndez-Jiménez, Marcos Bruna Esteban, Roberto Adriano Castro, Fabián Velázquez-Rebosa, Inmaculada Mesa-Ruiz, Javier Vaqué, Fernando Mingol-Navarro

{"title":"Fallo de rescate tras una esofagectomía. La importancia de registrar las complicaciones. Estudio retrospectivo a lo largo de 20 años","authors":"Silvia Carbonell-Morote, Miriam Menéndez-Jiménez, Marcos Bruna Esteban, Roberto Adriano Castro, Fabián Velázquez-Rebosa, Inmaculada Mesa-Ruiz, Javier Vaqué, Fernando Mingol-Navarro","doi":"10.1016/j.ciresp.2026.800376","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Esophageal cancer is a rare type of neoplasm in Western countries, yet it ranks as the seventh leading cause of death. Due to its anatomical location, esophageal surgery is a highly complex procedure. The morbidity and mortality associated with esophagectomy are significant, highlighting the need for a multidisciplinary approach to minimize complications. The measure of failure to rescue (FTR) reflects surgical outcomes and indicates the capacity to prevent death after a major complication (MC). It serves as a valuable metric for comparing results among different medical centers.</div></div><div><h3>Objective</h3><div>To evaluate the failure to rescue rate following esophagectomy at a high-volume tertiary esophageal surgery center.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed FTR, mortality, and morbidity rates following esophageal surgery from 2003 to 2024. Preoperative, intraoperative, and postoperative variables were assessed across patient groups. Comorbidities were evaluated using the ASA score, and complications were classified according to the Clavien-Dindo classification.</div></div><div><h3>Results</h3><div>268 patients underwent esophagectomy during the period of study. 129 (48%) experienced MC. Among these, 25 patients died within the first 90 days after surgery: FTR rate of 19.3%. Univariate and multivariate logistic regression analyses identified respiratory complications, including pneumonia and adult respiratory distress syndrome, as independent factors associated with FTR.</div></div><div><h3>Conclusion</h3><div>Respiratory complications are identified as the most significant risk factor for FTR following esophagectomy.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"104 9","pages":"Article 800376"},"PeriodicalIF":1.5000,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cirugia Espanola","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0009739X26013333","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/9/16 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Esophageal cancer is a rare type of neoplasm in Western countries, yet it ranks as the seventh leading cause of death. Due to its anatomical location, esophageal surgery is a highly complex procedure. The morbidity and mortality associated with esophagectomy are significant, highlighting the need for a multidisciplinary approach to minimize complications. The measure of failure to rescue (FTR) reflects surgical outcomes and indicates the capacity to prevent death after a major complication (MC). It serves as a valuable metric for comparing results among different medical centers.

Objective

To evaluate the failure to rescue rate following esophagectomy at a high-volume tertiary esophageal surgery center.

Methods

This retrospective study analyzed FTR, mortality, and morbidity rates following esophageal surgery from 2003 to 2024. Preoperative, intraoperative, and postoperative variables were assessed across patient groups. Comorbidities were evaluated using the ASA score, and complications were classified according to the Clavien-Dindo classification.

Results

268 patients underwent esophagectomy during the period of study. 129 (48%) experienced MC. Among these, 25 patients died within the first 90 days after surgery: FTR rate of 19.3%. Univariate and multivariate logistic regression analyses identified respiratory complications, including pneumonia and adult respiratory distress syndrome, as independent factors associated with FTR.

Conclusion

Respiratory complications are identified as the most significant risk factor for FTR following esophagectomy.

查看原文本刊更多论文

食道切除术后救援失败。记录并发症的重要性。20年回顾

食管癌在西方国家是一种罕见的肿瘤类型，但它是第七大死因。由于其解剖位置，食道手术是一个高度复杂的过程。与食管切除术相关的发病率和死亡率是显著的，强调需要多学科的方法来减少并发症。抢救失败（FTR）的测量反映了手术结果，并表明在发生重大并发症（MC）后预防死亡的能力。它是比较不同医疗中心的结果的一个有价值的指标。目的评价某大容量食道三级手术中心食管切除术后的抢救失败率。方法回顾性分析2003 - 2024年食道手术后的FTR、死亡率和发病率。术前、术中、术后变量在患者组间进行评估。使用ASA评分评估合并症，并根据Clavien-Dindo分类对并发症进行分类。结果268例患者在研究期间接受了食管切除术。129例（48%）发生MC，其中25例在术后90天内死亡，FTR率为19.3%。单因素和多因素logistic回归分析确定呼吸道并发症，包括肺炎和成人呼吸窘迫综合征，是与FTR相关的独立因素。结论呼吸系统并发症是食管切除术后发生FTR最重要的危险因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Cirugia Espanola SURGERY-

CiteScore

1.20

自引率

21.10%

发文量

173

审稿时长

53 days

期刊介绍： Cirugía Española, an official body of the Asociación Española de Cirujanos (Spanish Association of Surgeons), will consider original articles, reviews, editorials, special articles, scientific letters, letters to the editor, and medical images for publication; all of these will be submitted to an anonymous external peer review process. There is also the possibility of accepting book reviews of recent publications related to General and Digestive Surgery.