Clinical Study Of Serum Prealbumin Levels And Anastomotic Leak After Esophagectomy Of Esophageai Cancer

BackgroundEsophageal cancer is the fourth major cancer in China.Esophagectomy is the main treatment for esophageal cancer.Anastomotic leak(AL)is a common and serious complication of this surgery with significant morbidity and mortality.Early prediction and timely management of AL are crucial to patient recovery.ObjectiveIn this study,we evaluated the relationship between serum prealbumin levels and AL in patients with esophageal cancer,to explore the value of serum prealbumin as an early warning indicator of AL after esophagectomy.MethodsRetrospective analysis of 255 patients with esophageal cancer who met the criteria from January 2014 to December 2018,their basic characteristics and perioperative serum prealbumin levels were recorded.Statistical analysis by t test,nonparametric test.Univariate analysis andmultivariate logistic regression analysis were used to analyze data for patients with and without AL.Based on a receiver operator characteristic curve,a cut-off value for serum prealbumin levels as a predictor of AL was determined.ResultsAmong the 255 patients,Of these patients 141 underwent Sweet surgery,9 underwent Lvor-Lewis surgery,14 underwent McKeown surgery,and 91 underwent Minimally invasive esophagectomy surgery.18 patients were diagnosed with AL.The overall AL rate was 7.0%(18/255)including12 cases of intrathoracic AL and 6 cases of cervical AL.By univariate analysis,we identified postoperative serum prealbumin level as a risk factor for AL(P < 0.001).Multivariate analysis also demonstrated postoperative serum prealbumin level(p = 0.028)to be an independent risk factor for AL.The best cutoff value of postoperative serum prealbumin level was 131 mg/L for predicting AL,with 83.3% sensitivity and 72.2%specificity.ConclusionPostoperative serum prealbumin level was closely associated with the development of AL after esophagectomy.and it is the significant risk factor for the occurrence of anastomotic leak.Monitoring postoperative serum prealbumin level is helpful for the early warning of the occurrence of anastomotic leak.