Complications respiratoires de la chirurgie œsophagienne

The pulmonary complications represent the first cause of medical complications after esophagectomy. The risk factors implicated in the pulmonary complications development include preoperative factors that must be detected. The ventilatory strategy and especially the tidal volume used during the surgical procedure have been reported as an independent factor for further pulmonary complications after thoracic surgery. Preliminary results demonstrate that the use of reduced tidal volume and moderate PEEP during the one-lung ventilation period are able to preserve the lung function. The therapeutics used in case of pulmonary complications include an optimal analgesics control, an intensive physiotherapy and the non-invasive ventilation without risk of anastomotic leakage. The close relationship between medical and surgical complications leads to the constant research of an anastomotic leakage when a respiratory distress occurs.