Predictors of Anastomotic Leak After Esophagectomy for Cancer: Not All Leaks Increase Mortality.

Autor:	Krasnoff CC; Department of Surgery, University of California, Irvine, Orange, CA, USA., Grigorian A; Department of Surgery, University of California, Irvine, Orange, CA, USA., Smith BR; Department of Surgery, University of California, Irvine, Orange, CA, USA., Jutric Z; Department of Surgery, University of California, Irvine, Orange, CA, USA., Nguyen NT; Department of Surgery, University of California, Irvine, Orange, CA, USA., Daly S; Department of Surgery, University of California, Irvine, Orange, CA, USA., Lekawa ME; Department of Surgery, University of California, Irvine, Orange, CA, USA., Nahmias J; Department of Surgery, University of California, Irvine, Orange, CA, USA.
Jazyk:	angličtina
Zdroj:	The American surgeon [Am Surg] 2021 Jun; Vol. 87 (6), pp. 864-871. Date of Electronic Publication: 2020 Nov 24.
DOI:	10.1177/0003134820956329
Abstrakt:	Background: The impact of preoperative chemotherapy/radiation on esophageal anastomotic leaks (ALs) and the correlation between AL severity and mortality risk have not been fully elucidated. We hypothesized that lower severity ALs have a similar risk of mortality compared to those without ALs, and preoperative chemotherapy/radiation increases AL risk. Methods: The 2016-2017 American College of Surgeons National Surgical Quality Improvement Program's procedure-targeted esophagectomy database was queried for patients undergoing any esophagectomy for cancer. A multivariable logistic regression analysis was performed for risk of ALs. Results: From 2042 patients, 280 (13.7%) had ALs. AL patients requiring intervention had increased mortality risk including those requiring reoperation, interventional procedure, and medical therapy ( P < .05). AL patients requiring no intervention had similar mortality risk compared to patients without ALs ( P > .05). Preoperative chemotherapy/radiation was not predictive of ALs ( P > .05). Conclusion: Preoperative chemotherapy/radiation does not contribute to risk for ALs after esophagectomy. There is a stepwise increased risk of 30-day mortality for ALs requiring increased invasiveness of treatment.
Databáze:	MEDLINE
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