Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Lindenmann, J; Fink-Neuboeck, N; Porubsky, C; Fediuk, M; Anegg, U; Kornprat, P; Smolle, M; Maier, A; Smolle, J; Smolle-Juettner, FM.
A nomogram illustrating the probability of anastomotic leakage following cervical esophagogastrostomy.
Surg Endosc. 2021; 35(11):6123-6131
Doi: 10.1007/s00464-020-08107-0
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- Führende Autor*innen der Med Uni Graz
- Lindenmann Jörg
- Co-Autor*innen der Med Uni Graz
- Anegg Udo
- Fediuk Melanie
- Fink-Neuböck Nicole
- Kornprat Peter
- Maier Alfred
- Porubsky Christian
- Smolle Josef
- Smolle Maria Anna
- Smolle-Juettner Freyja-Maria
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- Abstract:
- BACKGROUND: Early diagnosis of anastomotic dehiscence following cervical esophagogastrostomy may become difficult. Estimation of an individual probability could help to establish preventive and diagnostic measures. The predictive impact of epidemiological, surgery-related data and laboratory parameters on the development of anastomotic dehiscence was investigated in the immediate perioperative period. METHODS: Retrospective study in 412 patients with cervical esophagogastrostomy following esophagectomy. Epidemiological data, risk factors, underlying disease, pre-treatment- and surgery-related data, C-reactive protein and albumin levels pre-and post-operatively were evaluated. We applied univariable and multivariable logistic regression analysis and developed a nomogram for individual risk assessment. RESULTS: There were 345 male, 67 female patients, mean aged 61.5 years; 284 had orthotopic, 128 retrosternal gastric pull-up; 331 patients had carcinoma, 81 non-malignant disease. Mean duration of operation was 184 min; 235 patients had manual, 113 mechanical and 64 semi-mechanical suturing; 76 patients (18.5%) developed anastomotic dehiscence clinically evident at mean 11.4 days after surgery. In univariable testing young age, retrosternal conduit transposition, manual suturing, high body mass index, high ASA and high postoperative levels of C-reactive protein were predictors for anastomotic leakage. These six parameters which had yielded a p < 0.1 in the univariable analysis, were entered into a multivariable analysis and a nomogram allowing the determination of the patient's individual risk was created. CONCLUSION: By using the nomogram as a supportive measure in the perioperative management, the patient's individual probability of developing an anastomotic leak could be quantified which may help to take preventive measures improving the outcome.
- Find related publications in this database (using NLM MeSH Indexing)
- Anastomosis, Surgical - adverse effects
- Anastomotic Leak - diagnosis, epidemiology, etiology
- Esophageal Neoplasms - surgery
- Esophagectomy - adverse effects
- Female - administration & dosage
- Humans - administration & dosage
- Male - administration & dosage
- Middle Aged - administration & dosage
- Nomograms - administration & dosage
- Retrospective Studies - administration & dosage
- Risk Factors - administration & dosage
- Find related publications in this database (Keywords)
- Cervical esophagogastrostomy
- Anastomotic leakage
- Risk factors
- Scoring
- Prediction
- Postoperative care