The Risk Factors for Refractory Fistula after Esophagectomy with Gastric Tube Reconstruction in Patients with Esophageal Cancer

被引:18
作者
Yamana, Ippei [1 ]
Takeno, Shinsuke [1 ]
Yamada, Teppei [1 ]
Sato, Keisuke [1 ]
Hashimoto, Tatsuya [1 ]
Yamashita, Yuichi [1 ]
机构
[1] Fukuoka Univ, Fac Med, Dept Surg Gastroenterol, Fukuoka, Japan
关键词
Refractory fistula; Esophagectomy; Gastric tube reconstruction; Anastomotic leakage; Esophageal cancer; ANASTOMOTIC LEAKAGE; COMPLICATIONS; PREDICTORS; CARCINOMA; MORTALITY;
D O I
10.1159/000447603
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background/Aims: Anastomotic leakage (AL) after esophagectomy is associated with high rates of postoperative morbidity and mortality. In cases with leakage, a refractory fistula (RF) is sometimes recognized after esophagectomy. The aim of this study was to evaluate the risk factors for RF after esophagectomy with gastric tube reconstruction. Methods: This study enrolled 244 consecutive esophageal cancer patients who had undergone esophagectomy with gastric tube reconstruction. RF was defined as a noncurative anastomotic site-cutaneous fistula that had been present for more than 2 months. We evaluated the risk factors for RF. Results: AL occurred in 30 patients (12.3%). There was one mortality case (0.4%) due to mediastinitis caused by AL in the present series. A multivariate analysis revealed that the subcutaneous route was an independent risk factor for AL (OR 4.42, 95% CI 1.42-13.8, p = 0.01), and that the subcutaneous route was an independent risk factor for RF (OR 13.30, 95% CI 2.50-71.30, p = 0.0024). Conclusion: The results of this retrospective study suggest that subcutaneous route was associated with an increased risk of RF after esophagectomy with gastric tube reconstruction. The preoperative identification of risk factors may contribute to the prevention of postoperative AL and RF. (C) 2016 S. Karger AG, Basel
引用
收藏
页码:18 / 24
页数:7
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