Fixed in the neck or pushed back into the thorax?-Impact of cervical anastomosis position on anastomosis healing.

Abstract:

Background:Cervical anastomotic leakage remains a great challenge for thoracic surgeons in the surgical treatment of esophageal cancer. Among the factors affecting cervical anastomosis healing, the surgical technique is the key controllable element. This study aimed to identify the risk factors of cervical anastomotic leakage after McKeown esophagectomy, especially those controllable surgical factors. Methods:A retrospective review of patients who underwent McKeown esophagectomy in the past eight years in West China Hospital was performed. Patients with cervical anastomotic leakage were assigned to leakage group (LG) while the left was enrolled in the none-leakage group (NLG). Multivariate logistic regression analysis was used to identify independent risk factors of anastomotic leakage. Results:A total of 518 patients were enrolled in the final analysis. In the baseline comparison, the difference in fixation of anastomosis in the neck, anastomosis mode, diabetes, and hypertension between the LG and NLG reached statistically significant. Moreover, the statistical difference of cervical fixation, anastomosis mode, and hypertension remained significant in the multivariate logistic regression analysis. Conclusions:The cervical anastomosis fixation, anastomosis mode, and hypertension are independent risk factors of gastroesophageal cervical anastomotic leakage.

journal_name

J Thorac Dis

authors

Luo J,Zhuo ZG,Zhu YK,Deng HY,Song TN,Alai GH,Shen X,Lin YD

doi

10.21037/jtd.2020.04.36

subject

Has Abstract

pub_date

2020-05-01 00:00:00

pages

2153-2160

issue

5

eissn

2072-1439

issn

2077-6624

pii

jtd-12-05-2153

journal_volume

12

pub_type

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