Analysis Of Risk Factors Of Anastomotic Leakage After Esophagectomy With Cervical Anastomosis

Objective:To analyze risk factors of anastomotic leakage after esophagectomy with cervical anastomosis, in order to explore methods to prevent and reduce the occurence of cervical anastomotic leakage.Methods:A retrospective analysis of clinical data of 709 cases,the patients were treated in Cancer Hospital of Chinese Academy of Medical Sciences..Refer to relevant literature and clinical practice combined with our department experience, we selected preoperative examination results,medical history, parameters of surgical procedure and tumor characteristics, depending on the measurement data and count data, respectively, t-test and X2 test for univariate analysis of risk factors associated with esophageal anastomotic fistula and Multivariate Logistic Regression analysis of the independent risk factors.Results:1. A total of 709 patients underwent esophagectomy with cervical anastomosis, with a total of 122(17.2%) anastomotic leaks. ASA risk class, prior thoracic surgery, upper digestive tract ulcer, COPD, hypertension, peripheral vascular disease, renal insufficiency, FEV1% predicted and DLCO% predicted were all associated with a statistically significant increase in risk of anastomotic leak (all P<0.05).2. Multivariable analysis of the preoperative factors, intraoperative variables, tumor characteristics including calcification of esophageal supplying arteries identified the following variables to be statistically associated with an increased risk of anastomotic leak:upper digestive tract ulcer, peripheral vascular disease, renal insufficiency, calcification of aorta and celiac axis.Results:1.upper digestive tract ulcer, peripheral vascular disease, renal insufficiency, calcification of descending aorta and celiac axis are independence risk factors of cervical esophageal anastomotic leakage.2.Patients who underwent esophgectmy with cervical anastomosis need positive preoperative therapy.3. calcification of descending aorta and celiac axis is a new risk factor for cervical esophageal anastomotic leakage.