Changing Realities After Cancer Surgery

Esophageal cancer surgery and delirium linked

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Did you know that it's not unusual for patients who have undergone major surgery to become delirious? It's true. In fact, coming in and out of consciousness, as well as the inability to process reality is actually common.

Following surgery, about half of all patients with esophageal cancer will suffer from delirium. Researchers have discovered the reason behind this puzzling trend.

"Ask your surgeon how to treat post-operative confusion."

Japanese researchers, led by Mari Takeuchi, MD, of the Department of Neuropsychiatry at Keio University School of Medicine in Tokyo, conducted a retrospective analysis (looking at past records) to determine the frequency of delirium and what caused it.

They analyzed data from 306 patients with esophageal cancer who had their esophagus removed, a procedure known as an esophagectomy. These operations took place between 1998-2009 at Keio University Hospital.

Psychiatrists assessed all the data, and the diagnosis of delirium was based on the criteria set forth in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition.

Exactly 50 percent of patients -- 153 of the 306 -- developed delirium, 114 of whom needed medication. Men were more likely than women to experience the condition.

The people who developed serious confusion likely received additional doses of the sedative flunitrazepam while in the intensive care unit (ICU). They were also more likely to be older and more likely to have developed some sort of complication after surgery, the researchers found.

The authors write that delirium after esophageal cancer "is a problem that cannot be ignored."

"Our results suggest that the risk of developing delirium is associated with older age, use of flunitrazepam in ICU, and postoperative complications," they conclude.

This study was published June 15, 2012 in the Annals of Surgery.

No financial disclosures were publicly available.

Reviewed by: 
Review Date: 
June 22, 2012
Last Updated:
November 7, 2012