Risk factors for anastomotic leakage after surgical resections for esophageal cancer

被引:14
作者
Herzberg, Jonas [1 ]
Strate, Tim [1 ]
Guraya, Salman Yousuf [2 ]
Honarpisheh, Human [1 ]
机构
[1] Krankenhaus Reinbek St Adolf Stift, Dept Surg, Hamburger Str 41, D-21465 Reinbek, Germany
[2] Univ Sharjah, Coll Med, Clin Sci Dept, Sharjah, U Arab Emirates
关键词
Esophageal resection; Esophageal cancer; Hypoproteinemia; Risk factors; Anastomotic leakage; POSTOPERATIVE COMPLICATIONS; SERUM-ALBUMIN; MANAGEMENT; JUNCTION; SURGERY; CHEMORADIOTHERAPY; MORTALITY; SURVIVAL; IMPACT; COHORT;
D O I
10.1007/s00423-021-02139-3
中图分类号
R61 [外科手术学];
学科分类号
摘要
Purpose Surgery for esophageal cancer is a challenging procedure that is associated with a high rate of complications such as sepsis, nutritional disorders, and anastomotic leakage (AL). The rate of complications following esophageal surgery rises exponentially in the presence of risk factors. This study aims to identify the risk factors for AL following esophageal cancer surgery. Methods In this retrospective study, we recorded comorbidities, tumor specific factors, nutritional status, and surgical complications of all patients who underwent surgical resections for esophageal cancers between January 2015 and December 2019. The occurrence of potential risk factors for AL was compared between groups with and without AL. We analyzed the categorical variables by Chi-square or Fisher's exact test, and the continuous variable by the Mann-Whitney U test and multivariable regression analyses. Results From 92 patients, AL was found in 12 (13%) patients. All cases with AL had hypoproteinemia; a protein level < 5 g/dl was an independent risk factor for AL (p value 0.009). The logistic regression analysis showed a positive correlation between hypoproteinemia and AL (coefficient 1.83, significance 0.01). Additionally, squamous cell carcinoma (SCC) of the esophagus had a positive correlation with AL (coefficient 1.89, significance 0.01). Conclusion In our study, hypoproteinemia and SCC were significant risk factors for AL after esophageal cancer surgery. Optimization of preoperative hypoproteinemia using a standardized nutritional protocol is recommended. More research is essential to determine the correlation of SCC with AL.
引用
收藏
页码:1859 / 1866
页数:8
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