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

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...

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Autores principales: Luo, Jun, Zhuo, Ze-Guo, Zhu, Yun-Ke, Deng, Han-Yu, Song, Tie-Niu, Alai, Gu-Ha, Shen, Xu, Lin, Yi-Dan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7330304/
https://www.ncbi.nlm.nih.gov/pubmed/32642120
http://dx.doi.org/10.21037/jtd.2020.04.36
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author Luo, Jun
Zhuo, Ze-Guo
Zhu, Yun-Ke
Deng, Han-Yu
Song, Tie-Niu
Alai, Gu-Ha
Shen, Xu
Lin, Yi-Dan
author_facet Luo, Jun
Zhuo, Ze-Guo
Zhu, Yun-Ke
Deng, Han-Yu
Song, Tie-Niu
Alai, Gu-Ha
Shen, Xu
Lin, Yi-Dan
author_sort Luo, Jun
collection PubMed
description 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.
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spelling pubmed-73303042020-07-07 Fixed in the neck or pushed back into the thorax?—Impact of cervical anastomosis position on anastomosis healing Luo, Jun Zhuo, Ze-Guo Zhu, Yun-Ke Deng, Han-Yu Song, Tie-Niu Alai, Gu-Ha Shen, Xu Lin, Yi-Dan J Thorac Dis Original Article 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. AME Publishing Company 2020-05 /pmc/articles/PMC7330304/ /pubmed/32642120 http://dx.doi.org/10.21037/jtd.2020.04.36 Text en 2020 Journal of Thoracic Disease. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Luo, Jun
Zhuo, Ze-Guo
Zhu, Yun-Ke
Deng, Han-Yu
Song, Tie-Niu
Alai, Gu-Ha
Shen, Xu
Lin, Yi-Dan
Fixed in the neck or pushed back into the thorax?—Impact of cervical anastomosis position on anastomosis healing
title Fixed in the neck or pushed back into the thorax?—Impact of cervical anastomosis position on anastomosis healing
title_full Fixed in the neck or pushed back into the thorax?—Impact of cervical anastomosis position on anastomosis healing
title_fullStr Fixed in the neck or pushed back into the thorax?—Impact of cervical anastomosis position on anastomosis healing
title_full_unstemmed Fixed in the neck or pushed back into the thorax?—Impact of cervical anastomosis position on anastomosis healing
title_short Fixed in the neck or pushed back into the thorax?—Impact of cervical anastomosis position on anastomosis healing
title_sort fixed in the neck or pushed back into the thorax?—impact of cervical anastomosis position on anastomosis healing
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7330304/
https://www.ncbi.nlm.nih.gov/pubmed/32642120
http://dx.doi.org/10.21037/jtd.2020.04.36
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