Analysis Of Related Factors Of Respiratory Failure After Minimally Invasive Esophagectomy And Establishment Of Prediction Model

Objectives:To investigate the current situation of respiratory failure in patients with minimally invasive esophageal cancer,analyze the factors affecting respiratory failure in patients with minimally invasive esophageal cancer,and construct a line graph model for predicting respiratory failure in patients with minimally invasive esophageal cancer,so as to assist clinical workers in personalizing the identification of patients at risk of respiratory failure after minimally invasive esophageal cancer,adjusting the treatment plan in time,and reducing the risk of respiratory failure in patients with minimally invasive esophageal cancer.MethodsRetrospective analysis Patients who underwent minimally invasive radical esophageal cancer surgery in the Department of Thoracic Surgery of our hospital from 01 2019 to December 2021 were selected for the study,including 228 male patients and 104 female patients,aged between 45-85 years old,with a mean age of 68.12±6.25 years,and were divided into a respiratory failure group(24 cases)and a non Respiratory failure group(308 cases),univariate multifactor analysis of indicators using logistic regression,and column line graph prediction model of respiratory failure after minimally invasive esophageal cancer surgery based on the independent risk factors obtained from multifactor analysis.The evaluation of the column line graph prediction model was based on receiver operating characteristic curve,area under curve,calibration curve and decision curve analysis.ResultIn this study,332 patients with esophageal cancer were included,predominantly male(228),accounting for 68.7%,with a mean patient age of 68.12±6.25 years,as evidenced by univariate analysis of age(P=0.005),MVV(P=0.013),FEV1(P=0.002),preoperative diabetes(P=0.044),preoperative combined COPD(P<0.001),operative time(P=0.027),intraoperative fluid replacement(P=0.012),number of lymph nodes cleared(P=0.047),extensive intraoperative chest adhesions(P=0.017),postoperative anastomotic fistula(P<0.001),and postoperative hypoproteinemia(P=0.003)were statistically significant,and the remaining factors were not statistically significant.Variables that were significant in univariate were included in the multifactorial analysis,and the variable screening method was stepwise.The results of multifactorial analy sis showed that age(p=0.015),intraoperative fluid volume(p=0.016),extensive intraoperative thoracic adhesions(p=0.025),FEV1(p=0.045),postoperative hypoproteinemia(p=0.014),preoperative combined COPD(p=0.008),and postoperative combined anastomotic fistula(p=0.031)were the minimally invasive postoperative esophageal cancer The independent risk factors for concomitant respiratory failure.The area under curve was 0.885(95%CI:0.822-0.947,p<0.001).The model calibration curve showed that the predicted probability of postoperative respiratory failure was consistent with the actual probability of occurrence,and the decision curve analysis suggested that the model had a good net benefit.ConclusionsAge,intraoperative fluid volume,extensive intraoperative thoracic adhesions,FEV1,postoperative hypoproteinemia,preoperative combined COPD,and postoperative combined anastomotic fistula are independent risk factors for respiratory failure after minimally invasive esophageal cancer surgery,and the column line graph prediction model based on the independent risk factors for postoperative respiratory failure can simply and effectively predict the risk of postoperative respiratory failure...