Pre-operative dental brushing can reduce the risk of postoperative pneumonia in esophageal cancer patients

• Published in: Surgery Vol. 147; no. 4; pp. 497 - 502
• Main Authors: Akutsu, Yasunori, MD, PhD, Matsubara, Hisahiro, MD, PhD, Shuto, Kiyohiko, MD, PhD, Shiratori, Toru, MD, PhD, Uesato, Masaya, MD, PhD, Miyazawa, Yukimasa, MD, PhD, Hoshino, Isamu, MD, PhD, Murakami, Kentaro, MD, Usui, Akihiro, MD, Kano, Masayuki, MD, Miyauchi, Hideaki, MD, PhD
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.04.2010; Elsevier
• Subjects: Antibiotic Prophylaxis; Bacteria - isolation & purification; Bacteria - pathogenicity; Bacterial Infections - prevention & control; Biological and medical sciences; Dental Plaque - complications; Dental Plaque - microbiology; Dental Plaque - prevention & control; Esophageal Neoplasms - surgery; Esophagus; Gastroenterology. Liver. Pancreas. Abdomen; General aspects; Humans; Medical sciences; Pneumonia - epidemiology; Pneumonia - prevention & control; Postoperative Complications - prevention & control; Preoperative Care; Risk Factors; Surgery; Thoracic Neoplasms - surgery; Toothbrushing - methods; Tumors; Human; Postoperative; Lung disease; Pneumonia; Respiratory disease; Esophageal disease; Brushing; Patient; Risk; Malignant tumor; Esophagus cancer; Medicine; Treatment; Surgery; Risk factor; Digestive diseases; Tooth; Cancer
• ISSN: 0039-6060; 1532-7361
• DOI: 10.1016/j.surg.2009.10.048

Background The presence of pathogens in dental plaque is a risk factor associated with postoperative pneumonia in esophageal cancer patients. The effectiveness of pre-operative dental brushing to decrease the risk of postoperative pneumonia in esophageal cancer patients was evaluated prospectively. Methods A total of 86 thoracic esophageal cancer patients who underwent an esophagectomy were investigated. Patients were divided into 2 groups: the control group (41 patients) and the pre-operative dental brushing group (45 patients). The patients in the brushing group were assigned to brush their teeth 5 times a day. After the operation, the frequency of postoperative pneumonia and need for tracheostomy for pulmonary treatment was calculated. Results Postoperative pneumonia was decreased markedly from 32% to 9% ( P = .013), and the frequency of postoperative pneumonia requiring tracheostomy decreased from 12% to 0% in the dental brushing group, respectively. Limiting the patients who had positive pathogenic bacteria in their dental plaque on their admission, the frequency of postoperative pneumonia was decreased from 71% (5 of 7 patients) in the control group to 17% (2 of 12 patients) in the dental brushing group ( P = .045). Conclusion Frequent pre-operative dental brushing is performed easily and seems to prevent postoperative pneumonia in esophageal cancer patients.