Aspiration pneumonia following oncologic digestive surgery: Proposal for a classification.

Postoperative aspiration pneumonitis (POAP) is a rare (1%) but worrying complication with a high mortality rate (up to 30%). 1 , 2 , 3 General anesthesia combined with gastrointestinal surgery induces digestive tract paralysis with the risk of delayed gastric emptying and consequent POAP. In the last two decades, efforts to decrease perioperative opioid use, 4 together with the rise of minimally invasive surgery, have reduced the surgical impact on digestive motility. In contrast, enhanced recovery after digestive surgery leads to decreased routine gastric tube feeding and increased early postoperative feeding, 5 , 6 , 7 , 8 which may induce gastric emptying and increase the risk of POAP, which remains a constant risk after digestive surgery, with various effects ranging from isolated radiologic signs to severe pneumonitis with multiorgan failure. To date, there have been no definitions or grading schemes for POAP, and it is difficult to draw realistic comparisons among perioperative drugs or procedures that could be effective in reducing POAP. Therefore, the present study seeks to develop a simple and reliable POAP classification that could facilitate relevant comparisons of preventive measures and postoperative courses.