Study On The Correlation Between Perioperative Inflammatory Indexes And Anastomotic Fistula After Esophageal Cancer Operation In Qinghai Area

Objective: To study the relationship between perioperative inflammatory indexes(CRP,ESR,PCT)of patients undergoing radical EC surgery and the occurrence of anastomotic leakage after EC,and to explore its predictive diagnostic value for postoperative anastomotic leakage.Methods: The subjects of this study were 150 patients with EC who underwent surgical treatment in the Affiliated Hospital of Qinghai University from Jan 2017 to Dec 2020.Among them,25 patients with anastomotic fistula after surgery were in the experimental group(anastomotic fistula group)),125 patients without anastomotic leakage after the operation served as the control group(no anastomotic leakage group).To retrospectively study the trends and numerical levels of changes in inflammatory indexes(CRP,ESR,PCT)in the two groups of patients during the perioperative period(before surgery and the 1st,3rd,5th,and 7th days after surgery).Non-parametric tests were used to compare gender,Whether the perioperative inflammatory indexes of the two groups of patients were statistically different in age.The binary logistic regression equation was used to evaluate whether there is a linear relationship between perioperative inflammatory indexes and anastomotic leakage.The receiver operating curve(ROC curve)was used to evaluate the predictive and diagnostic efficacy of three inflammatory indicators for anastomotic leakage.Results: Comparing the perioperative inflammatory indexes of the experimental group and the control group,there was no statistical difference in the inflammatory indexes before operation and the 1st day after operation(P>0.05);There was a difference in the inflammatory index at 7th days,which was statistically significant(P<0.05).The inflammatory index level in the anastomotic fistula group was higher than that in the non-anastomotic fistula group;the inflammatory index(CRP,CRP,ESR and PCT)were analyzed by binary logistic regression.At the two time nodes on the 3rd and 5th day,the 3 inflammatory indexes were linearly correlated with the anastomotic leakage(P<0.01),which was statistically significant.On the 7th day after surgery,the 3 inflammatory indexes were wirelessly correlated with anastomotic leakage(P>0.05).Draw the receiver operating curve(ROC curve)with the inflammatory index data on the 3rd,5th,and 7th day after operation,and it is concluded that when the inflammatory index is greater than the optimal cross-sectional value at each time node,the anastomotic fistula was equal,it has predictive diagnostic value.After further analysis of the statistical results,it is concluded that the CRP index has the largest area under the curve(AUC)on the 7th postoperative day and has the highest predictive diagnostic value;the ESR index has the largest AUC value on the 7th postoperative day and has the highest predictive diagnostic value;the PCT index is in operation The AUC value was the same on the5 th and 7th day after the operation,but the PCT index on the 5th day after the operation had higher sensitivity.In this study,the gender and age of the two groups of patients were compared,and there was no statistical difference(P>0.05).Conclusion: Inflammatory indicators(CRP,ESR,PCT)on the 3rd,5th,and 7th day after surgery for anastomotic leakage after esophageal cancer have certain predictive diagnostic value.The PCT index on the 5th day after the operation and the CRP and ESR indexes on the 7th day after the operation have the highest predictive and diagnostic value for anastomotic leakage after esophageal cancer.The inflammatory indexes(CRP,ESR,PCT)before operation and the first day after operation have no significant value in the predictive diagnosis of anastomotic leakage after esophageal cancer surgery.