scholarly journals Anastomotic leakage after esophagectomy for esophageal cancer: definitions, diagnostics, and treatment

2020 ◽  
Author(s):  
M Fabbi ◽  
E R C Hagens ◽  
M I van Berge Henegouwen ◽  
S S Gisbertz
Keyword(s):  
Risk Factors ◽  
Esophageal Cancer ◽  
Anastomotic Leakage ◽  
Postoperative Morbidity ◽  
Retrospective Studies ◽  
Recent Literature ◽  
Therapeutic Options ◽  
Treatment And Prevention ◽  
Diagnostic Modalities

Summary Anastomotic leakage is one of the most severe complications after esophagectomy and is associated with increased postoperative morbidity and mortality. Several projects ranging from small retrospective studies to large collaborations have aimed to identify potential pre- and perioperative risk factors and to improve the diagnostic processes and management. Despite the increase in available literature, many aspects of anastomotic leakage are still debated, without the existence of widely accepted guidelines. The purpose of this review is to provide a cutting edge overview of the recent literature regarding the definition and classification of anastomotic leakage, risk factors, novel diagnostic modalities, and emerging therapeutic options for treatment and prevention of anastomotic leakage following esophagectomy.

scholarly journals Anastomotic leakage after esophagectomy for esophageal cancer: risk factors and operative treatment

2021 ◽  
Vol 4 ◽  
pp. 8-8
Author(s):  
Sander Ubels ◽  
Moniek H. P. Verstegen ◽  
Camiel Rosman ◽  
John V. Reynolds
Keyword(s):  
Risk Factors ◽  
Esophageal Cancer ◽  
Cancer Risk ◽  
Anastomotic Leakage ◽  
Operative Treatment ◽  
Cancer Risk Factors

scholarly journals Risk Factors of Anastomotic Leakage After Esophagectomy With Intrathoracic Anastomosis

2021 ◽  
Vol 8 ◽  
Author(s):  
Huan Li ◽  
Shimin Zhuang ◽  
Honghong Yan ◽  
Wenxiao Wei ◽  
Quanguan Su
Keyword(s):  
Risk Factors ◽  
Esophageal Cancer ◽  
Hospital Stay ◽  
Anastomotic Leakage ◽  
Old Age ◽  
Multivariate Logistic Regression Analysis ◽  
Rank Correlation ◽  
Length Of Hospital Stay ◽  
Cancer Center ◽  
Intrathoracic Anastomosis

Purpose: Anastomotic leakage is one of the most common complications of esophagectomy, it serves as one of the main causes of postoperative death of esophageal cancer. It is of clinical significance to try to discover the risk factors that cause anastomotic leakage.Methods: This retrospective study was conducted on 1,257 consecutive esophageal cancer patients who underwent esophagectomy with intrathoracic anastomosis from January 2010 to December 2015 at a high volume cancer center. Multivariate Logistic Regression analysis, Spearman rank correlation analysis, Mann-Whitney U test and Kruskal-Wallis test were performed to identify the risk factors to the occurrence of anastomotic leakage and the length of hospital stay.Results: Intrathoracic anastomotic leakage occurred in 98 patients (7.8%). Older patients were more likely to develop anastomotic leakage. Patients with diabetes had a higher leakage rate. Intrathoracic anastomotic leakage, old age as well as comorbidities were associated with longer hospital stay.Conclusion: Our study suggested that old age and diabetes were risk factors to intrathoracic anastomotic leakage. In-hospital stay would be lengthened by intrathoracic anastomotic leakage, old age and comorbidities.

scholarly journals Myopia: Risk Factors, Disease Mechanisms, Diagnostic Modalities, and Therapeutic Options 2019

2020 ◽  
Vol 2020 ◽  
pp. 1-2
Author(s):  
Magorzata Mrugacz ◽  
Marzena Gajecka ◽  
Ewa Mrukwa-Kominek ◽  
Katarzyna J. Witkowska
Keyword(s):  
Risk Factors ◽  
Therapeutic Options ◽  
Disease Mechanisms ◽  
Diagnostic Modalities

Risk factors for anastomotic leakage after surgical resections for esophageal cancer

2021 ◽  
Author(s):  
Jonas Herzberg ◽  
Tim Strate ◽  
Salman Yousuf Guraya ◽  
Human Honarpisheh
Keyword(s):  
Risk Factors ◽  
Esophageal Cancer ◽  
Anastomotic Leakage

scholarly journals Myopia: Risk Factors, Disease Mechanisms, Diagnostic Modalities, and Therapeutic Options

2018 ◽  
Vol 2018 ◽  
pp. 1-2 ◽  
Author(s):  
Malgorzata Mrugacz ◽  
Marzena Gajecka ◽  
Ewa Mrukwa-Kominek ◽  
Katarzyna J. Witkowska
Keyword(s):  
Risk Factors ◽  
Therapeutic Options ◽  
Disease Mechanisms ◽  
Diagnostic Modalities

scholarly journals Anastomotic leakage and postoperative mortality in patients after esophageal cancer resection

2021 ◽  
Vol 49 (9) ◽  
pp. 030006052110455
Author(s):  
Quanguan Su ◽  
Chenxi Yin ◽  
Wei Liao ◽  
Haoxian Yang ◽  
Liying Ouyang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Esophageal Cancer ◽  
Propensity Score ◽  
Hospital Stay ◽  
Anastomotic Leakage ◽  
Propensity Score Matching ◽  
Significant Risk ◽  
Postoperative Mortality ◽  
Length Of Hospital Stay ◽  
Upper Thoracic

Objective Esophagectomy is a high-risk surgical procedure with significant postoperative morbidity and mortality. This study aimed to investigate the risk factors of cervical anastomotic leakage and postoperative mortality. Methods In this retrospective, observational study, we recruited 1010 patients with esophageal cancer. Cox regression analysis was performed to identify factors affecting anastomotic leakage and postoperative mortality. After propensity score matching, the Kaplan–Meier curve was used to evaluate the effect of leakage on postoperative mortality. Results The number of patients with cervical anastomotic leakage, in-hospital mortality, 30-day postoperative mortality, and 60-day postoperative mortality was 194 (19.2%), 13 (1.3%), 12 (1.2%), and 16 (1.6%), respectively. The total length of hospital stay and hospital stay postoperatively were 29.7 ± 21.1 and 21.3 ± 20.3 days, respectively. Diabetes, stage IV, and an upper thoracic tumor were significant risk factors for leakage. Leakage and diabetes were significant risk factors for postoperative mortality. After propensity score matching, leakage also significantly affected postoperative mortality. Conclusions Patients with tumors in the upper thoracic segment of the esophagus may be more prone to developing anastomotic leakage compared with those with tumors in the middle or lower thoracic segment. Anastomotic leakage may prolong the length of hospital stay and increase postoperative mortality.

PS01.132: RISK FACTORS OF ANASTOMOTIC LEAKAGE AFTER ESOPHAGECTOMY WITH GASTRIC TUBE RECONSTRUCTION FOR THORACIC ESOPHAGEAL CANCER

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 87-87
Author(s):  
Atsushi Sugimoto ◽  
Takahiro Toyokawa ◽  
Tatsuro Tamura ◽  
Katsunobu Sakurai ◽  
Naoshi Kubo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Esophageal Cancer ◽  
Anastomotic Leakage ◽  
Gastric Tube ◽  
Prognostic Score ◽  
Univariate Analysis ◽  
Circular Stapler ◽  
Thoracic Esophageal Cancer ◽  
Independent Risk Factors ◽  
Mechanical Anastomosis

Abstract Background Anastomotic leakage is a major complication after esophagectomy. Recent studies reported that anastomotic leakage is associated with poor prognosis. We aimed to identify the risk factors of anastomotic leakage after esophagectomy for thoracic esophageal cancer. Methods We analyzed retrospectively consecutive patients who underwent esophagectomy with reconstruction using gastric tube by cervical anastomosis for thoracic esophageal cancer between January 2009 and December 2017. In the reconstruction, end-to side mechanical anastomosis with circular stapler through the posterior mediastinal route was preferred until 2014, and end-to end hand-sewn anastomosis through the retrosternal route was preferred from 2015. As inflammation-based and/or nutritional markers, prognostic nutritional index (PNI), modified Glasgow Prognostic Score (mGPS), Controlling Nutritional Status (CONUT) score, and neutrophil lymphocyte ratio (NLR) were investigated. Receiver operator characteristic curve analyses were performed to set the cut-off value of continuous variables. Risk factors predicting anastomotic leakage were analyzed using logistic regression model. Results A total of 170 patients (144 males and 26 females) were evaluated. Median age was 65 years (59 − 70). Anastomotic leakage was observed in 21 patients (12.3%). A mechanical anastomosis with circular stapler (P = 0.047) and longer operative time (≧560 minutes) (P = 0.015) were identified as risk factors of anastomotic leakage in univariate analysis. Multivariate analysis including variables with P < 0.1 on univariate analyses identified lower PNI (< 45) (P = 0.044, OR 2.78, 95% CI: 1.02 − 7.56) and mechanical anastomosis with a circular stapler (P = 0.036, OR 3.30, 95% CI: 1.07 − 10.09) as independent risk factors. Conclusion Our findings suggested that preoperative lower PNI and mechanical anastomosis were independent risk factors of anastomotic leakage after esophagectomy. Further studies aimed at preoperative nutritional intervention and anastomotic technique are warranted. Disclosure All authors have declared no conflicts of interest.

scholarly journals FA01.02: THE EFFECT OF POSTOPERATIVE COMPLICATIONS AFTER MIE ON LONG-TERM SURVIVAL: A RETROSPECTIVE, MULTI-CENTER COHORT STUDY

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 1-1 ◽  
Author(s):  
Laura Fransen ◽  
Gijs Berkelmans ◽  
Emanuele Asti ◽  
Mark Van Berge Henegouwen ◽  
Felix Berlth ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Postoperative Complications ◽  
Anastomotic Leakage ◽  
Postoperative Morbidity ◽  
Cardiac Complications ◽  
Short Term ◽  
Term Survival ◽  
Long Term Survival ◽  
Grade 3

Abstract Background Esophagectomy has a high incidence of postoperative morbidity. Complications lead to a decreased short-term survival, however the influence of those complications on long-term survival is still unclear. Most of the performed studies are small, single center cohort series with inconclusive or conflicting results. Minimally invasive esophagectomy (MIE) has been shown to be associated with a reduced postoperative morbidity. In this study, the influence of complications on long-term survival for patients with esophageal cancer undergoing a MIE were investigated. Methods Data was collected from the EsoBenchmark database, a collaboration of 13 high-volume centers routinely performing MIE. Patients were included in this database from June 1, 2011 until May 31, 2016. Complications were scored according to the Clavien-Dindo (CD) classification for surgical complications. Major complications were defined as a CD grade ≥ 3. The data were corrected for 90-day mortality to correct for the short-term effect of postoperative complications on mortality. Overall survival was analyzed using the Kaplan Meier, log rank- and (uni- and multivariable) Cox-regression analyses. Results A total of 926 patients were eligible for analysis. Mean follow-up time was 30.8 months (SD 17.9). Complications occurred in 543 patients (59.2%) of which 39.3% had a major complication. Anastomotic leakage (AL) occurred in 135 patients (14.5%) of which 9.2% needed an intervention (CD grade ≥ 3). A significant worse long-term survival was observed in patients with any AL (HR 1.73, 95% CI 1.29–2.32, P < 0.001) and for patients with AL CD grade ≥3 (HR 1.86, 95% CI 1.32–2.63, P < 0.001). Major cardiac complications occurred in 18 patients (1.9%) and were related to a decreased long-term survival (HR 2.72, 95% CI 1.38–5.35, p 0.004). For all other complications, no significant influence on long-term survival was found. Conclusion The occurrence and severity of anastomotic leakage and cardiac complications after MIE negatively affect long-term survival of esophageal cancer patients. Disclosure All authors have declared no conflicts of interest.

Four-Corner Arthrodesis versus Proximal Row Carpectomy: Risk Factors and Complications Associated with Prolonged Postoperative Opioid Use

2020 ◽  
Author(s):  
Neill Y. Li ◽  
Alexander S. Kuczmarski ◽  
Andrew M. Hresko ◽  
Avi D. Goodman ◽  
Joseph A. Gil ◽  
...  
Keyword(s):  
Risk Factors ◽  
International Classification Of Diseases ◽  
Opioid Use ◽  
Proximal Row Carpectomy ◽  
Use Patterns ◽  
Patient Demographics ◽  
Implant Complications ◽  
Increased Risk ◽  
Classification Of Diseases

Abstract Introduction This article compares opioid use patterns following four-corner arthrodesis (FCA) and proximal row carpectomy (PRC) and identifies risk factors and complications associated with prolonged opioid consumption. Materials and Methods The PearlDiver Research Program was used to identify patients undergoing primary FCA (Current Procedural Terminology [CPT] codes 25820, 25825) or PRC (CPT 25215) from 2007 to 2017. Patient demographics, comorbidities, perioperative opioid use, and postoperative complications were assessed. Opioids were identified through generic drug codes while complications were defined by International Classification of Diseases, Ninth and Tenth Revisions, Clinical Modification codes. Multivariable logistic regressions were performed with p < 0.05 considered statistically significant. Results A total of 888 patients underwent FCA and 835 underwent PRC. Three months postoperatively, more FCA patients (18.0%) continued to use opioids than PRC patients (14.7%) (p = 0.033). Preoperative opioid use was the strongest risk factor for prolonged opioid use for both FCA (odds ratio [OR]: 4.91; p < 0.001) and PRC (OR: 6.33; p < 0.001). Prolonged opioid use was associated with an increased risk of implant complications (OR: 4.96; p < 0.001) and conversion to total wrist arthrodesis (OR: 3.55; p < 0.001) following FCA. Conclusion Prolonged postoperative opioid use is more frequent in patients undergoing FCA than PRC. Understanding the prevalence, risk factors, and complications associated with prolonged postoperative opioid use after these procedures may help physicians counsel patients and implement opioid minimization strategies preoperatively.

Sign in / Sign up

Export Citation Format

Share Document