Risk factors and prediction model of perioperative esophagogastric anastomotic leakage after esophageal cancer surgery
- VernacularTitle:围术期食管癌术后食管胃吻合口瘘的危险因素及预测模型的建立
- Author:
Hongxin NIE
1
,
2
,
3
;
Sihao YANG
4
;
Honggang LIU
4
;
Gaoping CAI
5
;
Dong CHAO
2
,
6
;
Hui MENG
4
Author Information
1. 1. Department of Cardiothoracic Surgery, The 940th Hospital of Joint Logistics Support Force of Chinese People&rsquo
2. s Liberation Army, Lanzhou, 730000, P. R. China
3. 2. School of the First Clinical Medicine, Gansu University of Chinese Medicine, Lanzhou, 730000, P. R. China
4. Department of Cardiothoracic Surgery, The Fifth Affiliated Hospital of Zunyi Medical University, Zhuhai, 519100, Guangdong, P. R. China
5. School of the First Clinical Medicine, Gansu University of Chinese Medicine, Lanzhou, 730000, P. R. China
6. Department of Cardiothoracic Surgery, The 940th Hospital of Joint Logistics Support Force of Chinese People&rsquo
- Publication Type:Journal Article
- Keywords:
Esophageal cancer;
anastomotic leakage;
risk factors;
prediction model
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2023;30(04):586-592
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the risk factors for esophagogastric anastomotic leakage (EGAL) after esophageal cancer surgery, and to establish a risk prediction model for early prevention and treatment. Methods Clinical data of patients undergoing esophagectomy in our hospital from January 2013 to October 2020 were retrospectively analyzed. The independent risk factors for postoperative EGAL were analyzed by univariate and multivariate logistic regression analyses, and a clinical nomogram prediction model was established. According to whether EGAL occurred after operation, the patients were divided into an anastomotic fistula group and a non-anastomotic fistula group. Results A total of 303 patiens were enrolled, including 267 males and 36 females with a mean age of 62.30±7.36 years. The incidence rate of postoperative EGAL was 15.2% (46/303). The multivariate logistic regression analysis showed that high blood pressure, chronic bronchitis, peptic ulcer, operation way, the number of lymph node dissected, anastomotic way, the number of intraoperative chest drainage tube, tumor location, no-supplementing albumin in the first three days after operation, postoperative pulmonary infection, postoperative use of bronchoscope were the independent risk factors for EGAL after esophageal cancer surgery (P<0.05). A prognostic nomogram model was established based on these factors with the area under the receiver operating characteristic curve of 0.954 (95%CI 0.924-0.975), indicating a high predictive value. Conclusion The clinical prediction model based on 11 perioperative risk factors in the study has a good evaluation efficacy and can promote the early detection, diagnosis and treatment of EGAL.
