Anastomotic leakage after intrathoracic versus cervical oesophagogastric anastomosis for oesophageal carcinoma in Chinese population: a retrospective cohort study.
BMJ Open
; 8(9): e021025, 2018 09 04.
Article
em En
| MEDLINE
| ID: mdl-30181184
ABSTRACT
OBJECTIVE:
To investigate the characteristics and predictors for anastomotic leakage after oesophagectomy for oesophageal carcinoma from the perspective of anastomotic level.DESIGN:
Retrospective cohort study. SETTINGS A single tertiary medical centre in China.PARTICIPANTS:
From January 2010 to December 2016, all patients with oesophageal cancer of the distal oesophagus or gastro-oesophageal junction undergoing elective oesophagectomy with a curative intent for oesophageal carcinoma with intrathoracic oesophagogastric anastomosis (IOA) versus cervical oesophagogastric anastomosis (COA) were included. We investigated anastomotic level and perioperative confounding factors as potential risk factors for postoperative leakage by univariate and multivariate logistic regression. PRIMARY OUTCOMEMEASURES:
The primary outcome was the odds of anastomotic leakage by different confounding factors. Secondary outcome was the association of IOA versus COA with other postoperative outcomes.RESULTS:
Of 458 patients included, 126 underwent cervical anastomosis and 332 underwent intrathoracic anastomosis. Anastomotic leakage developed in 55 patients (12.0%), with no statistical differences between COA and IOA (16.6% vs 10.2%; p=0.058). Multivariable analysis identified active diabetes mellitus (OR 2.001, p=0.047), surgical procedure (open reference; minimally invasive OR 1.770, p=0.049) and anastomotic method (semimechanical reference; stapled OR 1.821; handsewn OR 2.271, p=0.048) rather than anastomotic level (IOA reference; COA OR 1.622, p=0.110) were independent predictors of leakage.CONCLUSIONS:
Surgical and anastomotic techniques rather than the level of anastomotic site were independent predictors of postoperative anastomotic leakage in patients undergoing oesophageal cancer surgery.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Estômago
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Neoplasias Esofágicas
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Carcinoma
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Junção Esofagogástrica
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Esôfago
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Fístula Anastomótica
Tipo de estudo:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
Asia
Idioma:
En
Revista:
BMJ Open
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
China