619. ASSOCIATION OF PROLONGED ONE LUNG VENTILATION TIME WITH PERIOPERATIVE COMPLICATIONS IN PATIENTS UNDERGOING ESOPHAGOGASTRIC CANCER RESECTION

Abstract Introduction Esophagectomy for esophagogastric cancer is associated with high rates of peri-operative morbidity and mortality. Little is known of the impact of one lung ventilatory (OLV) times during the thoracic phase of an esophagectomy upon perioperative outcomes. The aim of this study was to determine the impact of OLV upon post-operative complications following esophagogastric cancer resection. Methods Consecutive patients undergoing an esophagectomy at a single, U.K tertiary referral centre for esophagogastric cancer between January 2015–January 2022 were evaluated. OLV time was defined as the number of minutes there was iatrogenic occlusion of one of the main bronchi such that all ventilatory requirements were performed by one lung. Previously published OLV times were used to determine if the duration was standard (<150 minutes) or prolonged (>=150 minutes). Post-operative complications were prospectively evaluated and classified using the Clavien-Dindo (CD) classification system. Patients were grouped as either CD 0-I (none-minor complications) or CD II-V (moderate–severe complications including post-operative mortality). Results There were 361 patients included in the final analysis. OLV times of <150 minutes were recorded in 101 patients and >=150 minutes were recorded in 260 patients. Both groups were comparable in terms of development of CDII-V complications with no statistically significant intergroup differences (91/101 vs 241/260; p=0.075). Notably, 41/91 (45.1%) of patients with an OLV time <150 minutes developed a pulmonary complication versus 100/241 (41.5%) with prolonged OLV times. Conclusion Pulmonary and other peri-operative complications remain a considerable burden in the recovery of patients following esophagogastric cancer resection, independant of OLV times. Strategies to mitigate this are need in order to reduce peri-operative morbidity and improve overall quality of life into survivorship.