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- Title
Predictors of Anastomotic Leak After Esophagectomy for Cancer: Not All Leaks Increase Mortality.
- Authors
Krasnoff, Chloe C.; Grigorian, Areg; Smith, Brian R.; Jutric, Zeljka; Nguyen, Ninh T.; Daly, Shaun; Lekawa, Michael E.; Nahmias, Jeffry
- Abstract
<bold>Background: </bold>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.<bold>Methods: </bold>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.<bold>Results: </bold>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).<bold>Conclusion: </bold>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.
- Subjects
AMERICAN College of Surgeons; ESOPHAGECTOMY; NEOADJUVANT chemotherapy; LOGISTIC regression analysis; REOPERATION; MORTALITY
- Publication
American Surgeon, 2021, Vol 87, Issue 6, p864
- ISSN
0003-1348
- Publication type
journal article
- DOI
10.1177/0003134820956329