Risk factors of cervical anastomotic leakage after thoracoscopic?lapacoscopic esophagectomy in patients with esophageal carcinoma
10.3760／cma.j.issn.0253?3766.2019.06.012
- VernacularTitle:胸腹腔镜联合食管癌根治术后发生颈部吻合口漏的危险因素
- Author:
Ziran ZHAO
1
;
Hao FENG
;
Shanrui MA
;
Yichao WANG
;
Qing MA
;
Gefei ZHAO
;
Xiaoli ZHANG
;
Huijun BAI
;
Liang ZHAO
Author Information
1. 国家癌症中心国家肿瘤临床医学研究中心中国医学科学院北京协和医学院肿瘤医院胸外科100021
- Keywords:
Esophageal neoplasms;
Esophagectomy;
Thoracoscopic?Laparoscopic;
Anastomotic Leakage;
Risk factors
- From:
Chinese Journal of Oncology
2019;41(6):460-465
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the risk factors of cervical anastomotic leakage after thoracoscopic?lapacoscopic esophagectomy. Methods 530 patients with esophageal cancer underwent thoracoscopic?lapacoscopic esophagectomy at the Cancer Hospital, Chinese Academy of Medical Sciences from Jan 2011 to Dec 2015. The demographic, surgical and clinical data of patients were retrospectively analyzed. Multivariate logistic regression was used to evaluate risk factors of cervical anastomotic leakage in these patients. Results A total of 530 patients undergoing thoracoscopic?lapacoscopic esophagectomy were enrolled in this study. There were 421 males and 109 females. The mean age was (59.40±8.08) years old, and 91 patients with cervical anastomotic leakage. Sigle factor analysis revealed that the risk grading by American Society of Aneshesiologists, previous history of chest surgery, respiratory comorbidity, diffusion capacity for carbon monoxide of the lung, operation time, anastomosis, average days of postoperative hospitalization, death within 30 days after surgery, respiratory complications, pleural effusion or empyema, and poor healing of the incision were statistically associated with cervical anastomotic leakage (all P＜0.05). Multivariate analysis showed that previous history of chest surgery, hepatic insufficiency, manual anastomosis, prolonged postoperative hospitalization, and poor healing of the incision were independent risk factors for cervical anastomotic leakage after thoracoscopic?lapacoscopic esophagectomy ( all P＜0.05 ). Conclusions Previous history of chest surgery, hepatic insufficiency, poor healing of the incision, manual anastomosis and prolonged postoperative hospitalization were significantly associated with cervical anastomotic leakage after thoracoscopic?lapacoscopic esophagectomy. It′s important to strengthen perioperative nursing and surgical techniques to prevent anastomotic leakage after thoracoscopic?lapacoscopic esophagectomy.
