ArticlePloS one2016
Short and Long-Term Outcomes of Epidural or Intravenous Analgesia after Esophagectomy: A Propensity-Matched Cohort Study.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
24 citing papers in PubMed, 55 citations in OpenAlex.
- Cost-effectiveness of Paravertebral versus EPidural analgesia in Minimally invasive Esophageal resectioN (PEPMEN): an economic evaluation alongside a randomized clinical trial.Surgical endoscopy · 2026Trial
- Comparison of the effects of perineural or intravenous dexamethasone on thoracic paravertebral block in Ivor-Lewis esophagectomy: A double-blind randomized trial.Clinical and translational science · 2022Trial
- Trial
- Epidurals in esophagectomy: end of an era?Journal of thoracic disease · 2026Article
- Epidural analgesia during esophagectomy and esophageal cancer prognosis: A population-based nationwide study in Finland.Acta anaesthesiologica Scandinavica · 2025Article
- [Epidural Analgesia in Minimally Invasive Esophagectomy: Evidence and Practice].Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition · 2025Review
- Prospective Survey of Postoperative Pain in Japan: A Multicenter, Observational Study.Journal of clinical medicine · 2025Article
- Analysis of factors related to anesthetic management affecting acute kidney injury occurring within 72 h after esophagectomy for esophageal cancer: a historical cohort study.JA clinical reports · 2024Article
- Impact of spinal or epidural anaesthesia on perioperative outcomes in adult noncardiac surgery: a narrative review of recent evidence.British journal of anaesthesia · 2024Review
- Trial watch: local anesthetics in cancer therapy.Oncoimmunology · 2024Article
- Evolving Perspectives on Esophagectomy Care: Clinical Update.Anesthesiology · 2023Article
- Article
- Short-Term Outcomes of Epidural Analgesia in Minimally Invasive Esophagectomy for Esophageal Cancer: Nationwide Inpatient Data Study in Japan.Annals of surgical oncology · 2022Article
- ASO Author Reflections: Epidural Analgesia Decreases In-Hospital Mortality, Respiratory Complications, and Anastomotic Leakage After Minimally Invasive Esophagectomy for Esophageal Cancer.Annals of surgical oncology · 2022Article
- Use of vasopressors during esophagectomy is not associated with increased risk of anastomotic leak.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2021Article
- Effects of Perioperative Epidural Analgesia on Cancer Recurrence and Survival.Frontiers in oncology · 2021Review
- The impact of epidural catheter insertion level on pain control after esophagectomy for esophageal cancer.Esophagus : official journal of the Japan Esophageal Society · 2020Article
- Article
- Influence of perioperative anaesthetic and analgesic interventions on oncological outcomes: a narrative review.British journal of anaesthesia · 2019Review
- The evolution of fast track protocols after oesophagectomy.Journal of thoracic disease · 2019Review
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesAs a well-established technique for postoperative pain relief, the benefits of epidural analgesia (EDA) have been under debate recently. This study aimed to determine whether EDA could improve perioperative outcomes and survival in patients undergoing esophagectomy.
methodsFrom January 2010 to December 2012, 587 consecutive cases undergoing McKeown-type esohpageactomy were retrospectively identified from a prospectively maintained database.
resultsAfter propensity-matching, incorporating baseline characteristics, 178 cases were included in each group, and patients characteristics distributions were well-balanced between two groups. Compared with intravenous analgesia, the use of EDA significantly decreased the incidence of pneumonia from 32% to 19.7% (P = 0.008), and anastomotic leakage from 23.0% to 14.0% (P = 0.029). The change in CRP level of EDA group was significantly decreased (preoperative, 6.2 vs. 6.2; POD 1, 108.1 vs. 121.3; POD 3, 131.5 vs. 137.8; POD 7, 69.3 vs. 82.1 mg/L; P = 0.044). EDA patients had a significantly longer duration of indwelling urinary catheter (P<0.001), and lower levels in both systolic (P = 0.001) and diastolic blood pressure (P<0.001). There weren't significant differences in overall survival (log-rank P = 0.47) and recurrence (Gray-test P = 0.46) between two groups.
conclusionsThese findings revealed that EDA could attenuate inflammatory response and reduce the incidence of pneumonia and anastomotic leakage after esophagectomy, at the price of delayed urinary catheter removal and lower blood pressure. EDA remains an important component of multimodal perioperative management after esophagectomy.
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