Analysis Of Risk Factors Of Anastomotic Leakage After Minimally Invasive Esophagectomy

Objective: To investigate and analyze risk factors of anastomotic leakage after minimally invasive esophagectomy, in order to explore minimally invasive methods to prevent and reduce anastomotic leakage occurred.Methods: A retrospective analysis of clinical data of 276 cases,the patients were treated in the second department of thoracic surgery in Fujian Medical University Union Hospital.Refer to relevant literature and clinical practice combined with our department experience, we selected 29 possible esophageal anastomotic leak-related factors, depending on the measurement data and count data,respectively, t-test and χ2 test for univariate analysis of risk factors associated with esophageal anastomotic fistula and Multivariate Logistic Regression analysis of the independent risk factors.Results: 1. The group of minimally invasive esophagectomy anastomotic fistula rate was 15.58% in 29 factors in univariate analysis: age, history of hypertension, a history of peptic ulcer, chronic gastritis, gastroesophageal anastomosis nine factors,location, route tubular stomach transplant, liver function abnormalities, pulmonary infection, postoperative bronchoscopy and sputum and other closely related esophageal anastomotic leakage(P<0.05), esophageal anastomotic fistula occurrence of risk factors. And with gender, diabetes, preoperative serum albumin level, preoperation radiotherapy,preoperative chemotherapy,chemotherapy, and so on fit no significant relationship(P≥0.05).2. Multivariate Logistic regression analysis showed: age ≥60 years(OR = 2.632, P = 0.008), a history of peptic ulcer before surgery(OR = 3.870, P = 0.019), tubular stomach migration path(OR =2.738, P = 0.034), in patients with impaired liver function(OR = 2.414, P = 0.015),postoperative pulmonary infection(OR = 3.430, P = 0.010) and other five factors are minimally invasive esophagectomy postoperative independent risk factors for anastomotic fistula.Conclusion: Our study find: age ≥60 years, preoperative history of upper gastrointestinal ulcers, stomach tube migration path, postoperative liver dysfunction and postoperative pulmonary infection are independence risk factors of esophageal anastomotic leakage, these factors involve preoperative patient health,surgery-related factors and postoperative recovery, so for patients of MIE still need to strengthen the perioperative management of patients and improve physical fitness,in order to prevent and reduce the esophagus anastomotic leakage occurred.