Analysis Of Risk Factors Of Cervical Anastomotic Leakage After Minimally Invasive Mckeown

Objective: To analyze the risk factors of cervical anastomotic leakage after minimally invasive Mckeown,and to propose a method to prevent and reduce cervical anastomotic leakage after minimally invasive Mckeown,so as to promote rapid recovery of patients,shorten the average hospitalization time and reduce the economic burden.Methods: A total of 38 patients in our group of thoracic surgery department of the First Hospital of Jilin University who underwent minimally invasive Mckeown,were analyzed from October 2018 to October 2019.Through the literature,in combination with the patient's history and intraoperative preoperative testing results.The basic statistic is to measure the length of pylorus to the end of right gastroepiploic arteries,and the length of the gastric conduit,and the length of pylorus to the end of right gastroepiploic arteries ratio to the length of stomach tube as a variable.The t-test was used to compare the mean of continuous data,and Pearson's ?2 test were used to compare categorical data.Results: There were 11 cases of cervical anastomotic leakage in 38 patients with cervical anastomosis after minimally invasive Mckeown.The incidence of cervical esophagogastric anastomotic leakage was 28.9%(11/38).After conservative treatment,all the 11 patients with anastomotic leakage recovered,and there were no deaths in hospital.The results of univariate analysis showed that serum albumin level on the first day after surgery,postoperative pulmonary complications,the length of right gastroepiploic artery,and the ratio of right gastroepiploic artery to gastric conduit length were independent risk factors for anastomotic leakage after minimally invasive Mckeown(P<0.05).Conclusion: For patients with esophageal cancer who underwent minimally invasive Mckeown surgery,previous medical history should be effectively controlled before surgery.The right gastroepiploic artery in the range of blood supply to the gastric conduit,albumin level on the first day after operation and postoperative pulmonary complications were independent risk factors for neck anastomotic fistula after minimally invasive Mckeown surgery.For patients with high risk of anastomotic leakage,clinical symptoms should be closely observed to prevent as soon as possible.