ZHAO Yun, CUI Jian. Research on the risk factors of anastomotic fistula after esophageal cancer surgery[J]. Journal of Clinical Medicine in Practice, 2024, 28(1): 37-40. DOI: 10.7619/jcmp.20232650
Citation: ZHAO Yun, CUI Jian. Research on the risk factors of anastomotic fistula after esophageal cancer surgery[J]. Journal of Clinical Medicine in Practice, 2024, 28(1): 37-40. DOI: 10.7619/jcmp.20232650

Research on the risk factors of anastomotic fistula after esophageal cancer surgery

More Information
  • Received Date: August 19, 2023
  • Revised Date: October 12, 2023
  • Available Online: January 22, 2024
  • Objective 

    To investigate the risk factors of anastomotic fistula after esophageal cancer surgery.

    Methods 

    The clinical data of 107 patients with esophageal cancer surgery were retrospectively analyzed, among whom 21 patients with anastomotic fistula after surgery were included in observation group, and 86 patients without anastomotic fistula after surgery were included in control group. The risk factors of anastomotic fistula after esophageal cancer surgery were identified by univariate analysis and multivariate Logistic regression analysis.

    Results 

    Univariate analysis showed that age, hypoproteinemia, history of diabetes, preoperative neoadjuvant therapy, and anastomotic site were associated with anastomotic fistula after esophageal cancer surgery (P < 0.05); multivariate Logistic regression analysis showed that preoperative neoadjuvant therapy was an independent risk factor for postoperative anastomotic fistula in patients with esophageal cancer (OR=5.392; 95%CI, 1.335 to 30.382; P=0.020).

    Conclusion 

    Preoperative neoadjuvant therapy is an independent risk factor for postoperative anastomotic fistula in patients with esophageal cancer. For patients with preoperative comorbid diseases, especially diabetes and hypoproteinemia, adequate preoperative preparation should be made.

  • [1]
    陈龙奇, 李小飞, 傅剑华, 等. 食管鳞癌术后随访中国胸外科专家共识[J]. 中国胸心血管外科临床杂志, 2022, 29(2): 141-149.
    [2]
    HIRANO Y, KONISHI T, KANEKO H, et al. Proportion of early extubation and short-term outcomes after esophagectomy: a retrospective cohort study[J]. Int J Surg, 2023, 109(10): 3097-3106. doi: 10.1097/JS9.0000000000000568
    [3]
    ELLIOTT J A, KLEVEBRO F, MANTZIARI S, et al. Neoadjuvant chemoradiotherapy versus chemotherapy for the treatment of locally advanced esophageal adenocarcinoma in the European multicenter ENSURE study[J]. Ann Surg, 2023, 278(5): 692-700. doi: 10.1097/SLA.0000000000006018
    [4]
    田烨, 周凌霄, 任光国. 1208例食管癌患者术后吻合口瘘风险因素分析[J]. 重庆医学, 2014, 43(15): 1924-1927.
    [5]
    靳凤梅, 李转梅. 食管癌术后颈部食管胃吻合口瘘的相关影响因素分析[J]. 实用癌症杂志, 2023, 38(1): 133-135.
    [6]
    林振孟, 郑辉哲, 严明芳, 等. 胃癌患者全胃切除术后吻合口瘘的危险因素及其预后[J]. 中华普通外科杂志, 2018, 33(10): 817-820.
    [7]
    LOW D E, ALDERSON D, CECCONELLO I, et al. International consensus on standardization of data collection for complications associated with esophagectomy: esophagectomy complications consensus group (ECCG)[J]. Ann Surg, 2015, 262(2): 286-294. doi: 10.1097/SLA.0000000000001098
    [8]
    苏瑜琛, 张建卫, 蒋勇, 等. 食管癌三切口术后吻合口良性狭窄的危险因素分析[J]. 中华胸部外科电子杂志, 2018, 5(4): 208-212.
    [9]
    LORENTZ T, FOK M, WONG J. Anastomotic leakage after resection and bypass for esophageal cancer: lessons learned from the past[J]. World J Surg, 1989, 13(4): 472-477. doi: 10.1007/BF01660760
    [10]
    杨博, 郝安林, 郭晓锋, 等. 管状胃-食管吻合术联合胸腔镜食管癌切除术对食管癌患者肺功能的影响[J]. 中国临床医生杂志, 2022, 50(12): 1464-1467.
    [11]
    李莉莉, 顾江魁, 李佳, 等. 食管癌术后早期肠内营养耐受与吻合口瘘的相关性探究[J]. 实用临床医药杂志, 2021, 25(24): 48-51. doi: 10.7619/jcmp.20212680
    [12]
    贾鑑慧, 刘飞, 任翼, 等. 食管癌原黏蛋白α3表达水平与食管癌患者病理特征的关系及其评估预后的价值[J]. 中国临床医生杂志, 2022, 50(5): 577-580.
    [13]
    LIU Y J, FAN J, HE H H, et al. Anastomotic leakage after intrathoracic versus cervical oesophagogastric anastomosis for oesophageal carcinoma in Chinese population: a retrospective cohort study[J]. BMJ Open, 2018, 8(9): e021025. doi: 10.1136/bmjopen-2017-021025
    [14]
    李蕾蕾. 食管癌术后吻合口瘘的非技术性危险因素分析[D]. 苏州: 苏州大学, 2018.
    [15]
    GAO H, FENG H M, LI B, et al. Impact of high body mass index on surgical outcomes and long-term survival among patients undergoing esophagectomy: a meta-analysis[J]. Medicine, 2018, 97(28): e11091. doi: 10.1097/MD.0000000000011091
    [16]
    聂洪鑫, 王兵, 杨思豪, 等. 食管癌术后食管胃吻合口瘘危险因素的系统评价与Meta分析[J]. 中国胸心血管外科临床杂志, 2022, 29(2): 166-178.
    [17]
    聂洪鑫. 围术期食管癌术后食管胃吻合口瘘的危险因素评价与研究[D]. 兰州: 甘肃中医药大学, 2021.
    [18]
    SAKURAI K, TAMURA T, TOYOKAWA T, et al. Low preoperative prognostic nutritional index predicts poor survival post-gastrectomy in elderly patients with gastric cancer[J]. Ann Surg Oncol, 2016, 23(11): 3669-3676. doi: 10.1245/s10434-016-5272-6
    [19]
    张帆. 食管癌术后吻合口瘘的研究进展[D]. 石家庄: 河北医科大学, 2016.
    [20]
    王尧, 黄利荣, 施东辉, 等. 食管癌术后颈部与胸内吻合口瘘发生的影响因素分析[J]. 中国医学工程, 2021, 29(2): 96-99.
    [21]
    HONG Z N, XU J X, CHEN Z, et al. Additional neoadjuvant immunotherapy does not increase the risk of anastomotic leakage after esophagectomy for esophageal squamous cell carcinoma: a multicenter retrospective cohort study[J]. Int J Surg, 2023, 109(8): 2168-2178. doi: 10.1097/JS9.0000000000000487
    [22]
    NILSSON M. The combination of respiratory comorbidity and neoadjuvant chemoradiotherapy may double the risk of anastomotic leaks after esophagectomy: do we know enough to tailor neoadjuvant therapies, or take other preemptive measures in high-risk patients[J]. Ann Surg Oncol, 2019, 26(9): 2660-2661. doi: 10.1245/s10434-019-07485-7
    [23]
    ROH S, IANNETTONI M D, KEECH J, et al. Timing of esophagectomy after neoadjuvant chemoradiation therapy affects the incidence of anastomotic leaks[J]. Korean J Thorac Cardiovasc Surg, 2019, 52(1): 1-8. doi: 10.5090/kjtcs.2019.52.1.1
    [24]
    刘占豪, 耿昕, 李春艳, 等. VFP新辅助化疗方案对局部晚期食管癌手术治疗影响的临床研究[J]. 黑龙江医学, 2014, 38(7): 777-778.
    [25]
    王宝, 曲明江, 邹勤光, 等. 食管癌术后吻合口瘘原因及治疗[J]. 中国老年学杂志, 2017, 37(22): 5634-5635.
    [26]
    刘欣源. 中医医疗服务技术项目基本医疗保险目录准入管理研究[D]. 北京: 中国中医科学院, 2022.
  • Related Articles

    [1]LI Jia, WANG Lin, LIU Nan, WANG Ting, ZHAO Xiaoya, GAO Lini, ZHAO Ping. Effect of mindfulness training on sleep quality and psychological state of perimenopausal patients with insomnia[J]. Journal of Clinical Medicine in Practice, 2022, 26(23): 85-88. DOI: 10.7619/jcmp.20222790
    [2]LIN Yan, ZHOU Ping, LI Yanzhen, LI Shiting. Effect of preoperative anxiety and depression and sleep qualityon sequelae of Bell's palsy and its intervention strategy[J]. Journal of Clinical Medicine in Practice, 2021, 25(7): 30-33. DOI: 10.7619/jcmp.20201495
    [3]XI Lijuan, WANG Daorong, FANG Fang, YUAN Haijuan. Mediating effect of depression on sleep and preoperative frailty in elderly patients with gastrointestinal cancer[J]. Journal of Clinical Medicine in Practice, 2021, 25(5): 50-54. DOI: 10.7619/jcmp.20201747
    [4]ZHANG Zhanhua, TIAN Feng. Expression of serum cortisol levels in post-stroke depression patients before and after treatment and its correlation with depression[J]. Journal of Clinical Medicine in Practice, 2019, 23(24): 34-36. DOI: 10.7619/jcmp.201924011
    [5]MEI Jing, WANG Chungang, BO Lin. Effect of SSRI anti depression drugs combined with conventional drugs for cerebral vascular disease on treatment of patients with post stroke depression[J]. Journal of Clinical Medicine in Practice, 2017, (1): 25-27. DOI: 10.7619/jcmp.201701007
    [6]CHEN Rende. The effect of duloxetine on sleeping quality of elderly female patients with depression[J]. Journal of Clinical Medicine in Practice, 2015, (Z1): 159-160.
    [7]JIA Jing, QIANG Xiaoling. Influence of comprehensive nursing interventions on depressive emotion and QOL in patients with depression[J]. Journal of Clinical Medicine in Practice, 2015, (16): 14-16. DOI: 10.7619/jcmp.201516005
    [8]QIU Yanli. The influence of psychological nursing intervention combined with massage on postpartum depression of patients[J]. Journal of Clinical Medicine in Practice, 2015, (2): 77-79,83. DOI: 10.7619/jcmp.201502024
    [9]Study on the relationship between quality of life and self-efficacy of patients with depressive disorder[J]. Journal of Clinical Medicine in Practice, 2014, (20): 15-18. DOI: 10.7619/jcmp.201420005
    [10]SONG Wenying. Influence of nursing intervention on the quality of life of patients with depression[J]. Journal of Clinical Medicine in Practice, 2013, (16): 147-149. DOI: 10.7619/jcmp.201316057
  • Cited by

    Periodical cited type(25)

    1. 刘珊励,刘金叶,陈叶奇. 甘精胰岛素与预混胰岛素分别联合阿卡波糖对2型糖尿病患者血糖控制及胰岛素用量的影响. 糖尿病新世界. 2024(15): 91-94 .
    2. 佘其美,董亚苒,王新芳,玉晓露,程景丽,裴倩倩,谷贵燕,李湘. 分析甘精胰岛素联合磷酸西格列汀治疗老年2型糖尿病(T2DM)的临床效果. 糖尿病新世界. 2023(04): 116-119+123 .
    3. 魏伟. 甘精胰岛素联合重组人胰岛素强化治疗2型糖尿病的临床效果. 临床合理用药. 2023(23): 98-101 .
    4. 毛财凤. 甘精胰岛素联合口服降糖药治疗血糖控制不佳的2型糖尿病患者的临床效果. 中国医学创新. 2023(25): 16-20 .
    5. 郑清华,时维琼,刘慧丽. 胰岛素联合平衡盐溶液对老年重度糖尿病酮症酸中毒患者β2微球蛋白、FT4水平的影响. 中国老年学杂志. 2022(08): 1816-1819 .
    6. 刘利. 利格列汀联合度拉糖肽对2型糖尿病患者临床疗效研究. 天津药学. 2022(02): 63-65+71 .
    7. 陈钦榜,何英. 阿卡波糖联合甘精胰岛素对2型糖尿病患者的疗效及不良反应的影响. 糖尿病新世界. 2022(13): 81-84 .
    8. 张魁星. 甘精胰岛素联合二甲双胍治疗2型糖尿病的效果分析. 现代诊断与治疗. 2022(18): 2717-2719 .
    9. 张子毅,郭静超. 甘精胰岛素联合二甲双胍对初发2型糖尿病患者血糖水平和胰岛β功能的影响. 实用糖尿病杂志. 2021(01): 99-100 .
    10. 王利平. 阿卡波糖和胰岛素治疗老年2型糖尿病的效果和安全性. 中国当代医药. 2021(11): 76-78 .
    11. 冯聪. 2型糖尿病应用长效胰岛素联合口服降糖药治疗的有效性研究. 中国实用医药. 2021(20): 136-138 .
    12. 黄新峰. 2型糖尿病治疗中甘精胰岛素联合瑞格列奈的应用安全性分析. 黑龙江中医药. 2021(04): 35-36 .
    13. 房思思. 长效胰岛素联合口服降糖药治疗2型糖尿病的疗效与安全性. 中国实用医药. 2021(27): 114-116 .
    14. 汪俊. 甲巯咪唑联合甘精胰岛素对糖尿病伴甲亢的疗效分析. 医学食疗与健康. 2021(08): 58-59 .
    15. 李华荣,余婷. 麦味地黄汤加减联合消渴丸治疗2型糖尿病临床效果观察. 现代诊断与治疗. 2021(21): 3380-3381 .
    16. 林小玲. 甘精胰岛素联合阿卡波糖治疗老年糖尿病的临床疗效及安全性分析. 中国现代药物应用. 2020(09): 170-171 .
    17. 陈维平,谢芸. 沙格列汀联合胰岛素用药在2型糖尿病治疗中的临床作用. 中外医学研究. 2020(15): 136-138 .
    18. 何德卓. 甘精胰岛素联合阿卡波糖治疗2型糖尿病临床观察. 北方药学. 2020(06): 104-105 .
    19. 张明谦. 甘精胰岛素和预混胰岛素治疗2型糖尿病的临床效果比较. 福建医药杂志. 2020(03): 174-175 .
    20. 林玉平. 甘精胰岛素联合门冬胰岛素治疗对T2DM患者的血糖控制效果. 海峡药学. 2020(08): 190-192 .
    21. 龙爱梅,武红梅,邓丽萍,黄妙玲,何圣清,张帆. 甘精胰岛素和预混胰岛素分别联合阿卡波糖治疗2型糖尿病效果差异. 中国处方药. 2020(10): 105-106 .
    22. 王玲,赵岚. 糖尿病患者阿卡波糖治疗的临床疗效研究进展. 实用心脑肺血管病杂志. 2020(S1): 282-283 .
    23. 孙景. 甘精胰岛素联合瑞格列奈治疗2型糖尿病的价值研究. 海峡药学. 2020(10): 155-156 .
    24. 张琼珍. 预混胰岛素类似物与基础胰岛素对128例2型糖尿病患者起始胰岛素治疗的临床疗效分析. 糖尿病新世界. 2020(22): 34-36 .
    25. 何燕. 基础胰岛素联合阿卡波糖对比预混胰岛素治疗2型糖尿病的临床效果分析. 糖尿病新世界. 2020(24): 94-96 .

    Other cited types(0)

Catalog

    Article views (125) PDF downloads (13) Cited by(25)

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return