The effect of the volume of infusion therapy on the first operating days after Lewis esophageal resection with gastric esophagoplasty (combined laparotomy and thoracotomy access on the right) on the course of the postoperative period and outcomes in cancer patients

Aim.  To study the effect of volume infusion on the first 24 hours after Lewis esophageal resection with gastric esophagoplasty (combined laparotomy and thoracotomy access on the right) on the immediate results and outcomes in cancer patients.

Materials and methods. The study retrospectively included patients who underwent Lewis resections of the esophagus with gastric esophagoplasty (combined laparotomy and thoracotomy access on the right) for malignant neoplasms of esophagus, as well as cardioesophageal cancer at the N.N. Blokhin National Medical Research Center of Oncology in 2023.

Results. Forty patients were included in the study. The patients were divided into 2 groups based on the median rate of daily infusion therapy: in patients of group 1 (n = 21) on the 1^st day of surgery, the intravenous infusion rate was ≥4 ml/kg/day, in patients of group 2 (n = 19) – <4 ml/kg/day. The complication rate was 47.7 % (n = 10) in group 1 and 84.2 % (n = 16) – in group 2 (p = 0.021). The incidence of complications ≥III grade according to Clavien–Dindo classification did not differ in both groups (p = 1.000). The incidence of postoperative deep vein thrombosis was 4.8 % (n = 1) in group 1 and 31.6 % (n = 6) in group 2 (p = 0.039). Ninety-day postoperative mortality was not observed in any of the groups. The length of hospital stay for patients in group 1 was 17 (15–18) days, in group 2 –16 (14–20) days (p = 0.707).

Conclusion. The results of the study revealed that the number of common complications and the frequency of postoperative deep vein thrombosis in patients of the group 2, who received a daily infusion volume of <4 ml/kg/day, was higher than in patients of the group 1. 

The data from this study should be taken into account when planning infusion therapy in patients with esophageal malignancies and cardioesophageal cancer during Lewis esophageal resections with gastric esophagoplasty (combined laparotomy and thoracotomy access on the right).

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