The effect of perioperative oral management on prevention of postoperative pneumonia in patients undergoing esophageal resection

―Analysis by a multicenter, retrospective study―

Abstract

Postoperative pneumonia is a frequent and possibly fatal complication of esophagectomy, and is likely caused by aspiration of oropharyngeal fluid that contains pathogenic microorganisms. The Japan Study Group of Co-operative Dentistry with Medicine (JCDM) conducted a multicenter retrospective study to investigate the preventive effect of perioperative oral management on postoperative pneumonia among patients with esophageal cancer who underwent esophagectomy.
A total of 383 patients underwent esophagectomy at six university hospitals. These patients were divided into patients who received perioperative oral management from dentists and dental hygienists (oral care group, n＝234) and patients who did not receive preoperative oral care (control group, n＝149). The distribution into the two groups was not random but historical. We evaluated the correlations between the occurrence of postoperative pneumonia and 18 predictive variables (patient factors, tumor factors, treatment factors, postoperative dysphagia, and preoperative oral care) using Fisher’s exact test and Logistic regression analysis.
Smoking habit, postoperative dysphagia, and absence of perioperative oral management were significantly correlated with postoperative pneumonia in the univariate analysis. Multivariate analysis revealed that diabetes, postoperative dysphagia, and the absence of perioperative oral management were independent risk factors for postoperative pneumonia.
These findings show that perioperative oral management may be an effective and easy method to prevent postoperative pneumonia in patients who are undergoing esophagectomy.