Clinical factors associated with rescue bronchoscopic sputum suction after minimally invasive esophagectomy: A single-center retrospective study.

Abstract

Purpose: Postoperative sputum retention after minimally invasive esophagectomy may require bronchoscopic sputum suction when conservative airway clearance is insufficient. However, the clinical features associated with this intervention remain unclear.

Methods: We retrospectively reviewed the data of 145 patients who underwent minimally invasive esophagectomy for thoracic esophageal cancer. Patients were divided into those who required postoperative bronchoscopic sputum suction and those who did not. Clinicopathological factors, surgical outcomes, Brinkman Index, pulmonary function, and postoperative complications were compared.

Results: Postoperative bronchoscopic sputum suction was required in 21 patients. All bronchoscopic procedures were performed after transfer from the intensive care unit to the general ward. The bronchoscopic group had a significantly higher Brinkman Index than the no-bronchoscopic group, whereas standard spirometric parameters, including forced vital capacity, forced expiratory volume in 1 s, and the forced expiratory volume in 1 s percentage, did not differ between the groups. Patients requiring bronchoscopy had higher rates of postoperative pneumonia and anastomotic leakage and a significantly longer postoperative hospital stay.

Conclusion: In patients undergoing minimally invasive esophagectomy, greater cumulative smoking exposure was associated with rescue bronchoscopic sputum suction despite comparable preoperative spirometry. Therefore, a high Brinkman index may indicate the need for closer postoperative respiratory surveillance and timely airway clearance.