Neoplasms

Digestive System Diseases

All Conditions

Gland and Hormone Related Diseases

Rare Diseases

Colorectal Neoplasms

Pancreatic Neoplasms

Stomach Neoplasms

Gastrointestinal Neoplasms

Digestive System Neoplasms

Gastrointestinal Diseases

Intestinal Neoplasms

Colonic Diseases

Intestinal Diseases

Rectal Diseases

Stomach Diseases

Pancreatic Cancer

Stomach Cancer

Central Nervous System Depressants

All Drugs and Chemicals

Adjuvants, Anesthesia

Analgesics

Platelet Aggregation Inhibitors

Anticonvulsants

Anesthetics

Fentanyl

Nitrous Oxide

Sevoflurane

Thiopental

Vecuronium Bromide

Group air was mechanically ventilated using 35% oxygen in 65% air during the whole surgical procedure.

Thiopental sodium was used for induction of anesthesia, muscle relaxation was maintained with vecuronium. General anesthesia with sevoflurane was maintained during the surgical procedure. Intraoperative analgesia was achieved with fentanyl boluses.

Group N2O was mechanically ventilated using 35 % oxygen and 65 % of nitrous oxyde during the surgical procedure.

Nitrous oxyde may increase cuff pressure during the general endotracheal anesthesia and result in the respiratory symptoms like sore throat, hoarseness and postoperative cough.

Thiopental sodium was used for induction of anesthesia, muscle relaxation was maintained with vecuronium. General anesthesia with sevoflurane was maintained during the surgical procedure. Intraoperative analgesia was achieved with fentanyl boluses.

Nitrous oxyde and sevoflurane anesthesia may alter mucus transport in the early postoperative period. In colonized patients it may result in more respiratory complications.

Tracheal aspirates and nasal smears were taken in all the patients. Laparotomies were performed in all patients.

Slavica Kvolik, MD, PhD

The goals of this study were to investigate whether two anesthesia regimens, with and without N2O, and bacterial colonization influence respiratory complications after major abdominal surgery for cancer.

A study was approved by institutional ethics committee. All patients were informed on the study protocol by attending anesthesiologist on the day of the surgery and written informed consent was obtained. Patients with clinically or radiologically confirmed acute respiratory infections or those using antibiotics due to the respiratory infections a week prior to the surgery were not included in the study. Following risk factors were recorded in all patients: age, sex, weight loss in the last 6 months, comorbidities and operative time. Comorbidities were rated using ASA status and Charlson comorbidity index by 3 independent observers. Charlson comorbidity index was calculated after pathological examination. An advanced malignant disease was considered if tumor had infiltrated other organs or surrounding tissues, or when positive lymph nodes or metastases were confirmed.

A group of 120 colorectal, gastric, or pancreatic cancer patients scheduled for surgery in the single centre were included in the prospective randomized study regardless of their ASA physical status. Nasopharyngeal smears were obtained in the preoperative area and tracheal aspirates were obtained in the operating room at the end of the surgery with a sterile suction catheter in a closed system.

Postoperative Hgb; CRP and lung auscultation were done in all patients on the second and fourth postoperative day.

Outcome measures registered were:

* Postoperative pneumonia
* Productive and difficult cough
* Dysphonia
* Congestive heart failure
* postoperative complications, including hypertensive crisis, thromboembolic and infective complications were summarized one year after surgical treatment was finished \& one year survival

To investigate whether productive cough, dyspnea and hoarseness were different between two groups of patients. Group Air received sevoflurane anesthesia with 35% O2 in air, and Group N2O received sevoflurane anesthesia with 35% O2 in N2O

Postoperative outcomes were registered by doctor who did not know type of anesthesia delivered

Tracheal Colonization and Outcome After Major Abdominal Cancer Surgery

Upon the request all blinded individual participant data (IPD) may be available to other researchers

Number of patients who reported the presence of cough, dyspnea and/or abnormal findings on lung examination, and two of following: fever, leukocytosis or high CRP, and positive chest radiograms.

patients without auscultatory findings who self reported that they have productive sputum and painful expectoration without laboratory and RTG findings suggestive for pneumonia

The patients who self-reported hoarseness and changed voice

All the other postoperative complications, including in-hospital hypertensive crisis, thromboembolic and infective complications were summarized one year after surgical treatment was finished.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
Tracheal Colonization and Outcome After Major Abdominal Cancer Surgery	NCT04002128	Colorectal Neop... Surgical Proced... Stomach Neoplas... Pancreatic Canc...	Tracheal aspira...	18 Years - 90 Years	Osijek University Hospital
Tracheal Colonization and Outcome After Major Abdominal Cancer Surgery	NCT04002128	Colorectal Neop... Surgical Proced... Stomach Neoplas... Pancreatic Canc...	Tracheal aspira...	18 Years - 90 Years	Osijek University Hospital

Spots Global Cancer Trial Database for tracheal aspirates and nasal smears were taken in all the patients. laparotomies were performed in all patients.