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Patient-Related Prognostic Factors for Anastomotic Leakage, Major Complications, and Short-Term Mortality Following Esophagectomy for Cancer: A Systematic Review and Meta-Analyses
- Source :
- Annals of Surgical Oncology, 29, 1358-1373. SPRINGER, Annals of Surgical Oncology
- Publication Year :
- 2022
-
Abstract
- Objective The aim of this study is to identify preoperative patient-related prognostic factors for anastomotic leakage, mortality, and major complications in patients undergoing oncological esophagectomy. Background Esophagectomy is a high-risk procedure with an incidence of major complications around 25% and short-term mortality around 4%. Methods We systematically searched the Medline and Embase databases for studies investigating the associations between patient-related prognostic factors and anastomotic leakage, major postoperative complications (Clavien–Dindo ≥ IIIa), and/or 30-day/in-hospital mortality after esophagectomy for cancer. Results Thirty-nine eligible studies identifying 37 prognostic factors were included. Cardiac comorbidity was associated with anastomotic leakage, major complications, and mortality. Male sex and diabetes were prognostic factors for anastomotic leakage and major complications. Additionally, American Society of Anesthesiologists (ASA) score > III and renal disease were associated with anastomotic leakage and mortality. Pulmonary comorbidity, vascular comorbidity, hypertension, and adenocarcinoma tumor histology were identified as prognostic factors for anastomotic leakage. Age > 70 years, habitual alcohol usage, and body mass index (BMI) 18.5–25 kg/m2 were associated with increased risk for mortality. Conclusions Various patient-related prognostic factors are associated with anastomotic leakage, major postoperative complications, and postoperative mortality following oncological esophagectomy. This knowledge may define case-mix adjustment models used in benchmarking or auditing and may assist in selection of patients eligible for surgery or tailored perioperative care.
- Subjects :
- Male
medicine.medical_specialty
Esophageal Neoplasms
medicine.medical_treatment
Anastomotic Leak
Disease
Diabetes mellitus
medicine
Humans
Thoracic Oncology
Aged
Retrospective Studies
business.industry
Incidence (epidemiology)
Cancer
medicine.disease
Prognosis
Comorbidity
Surgery
Esophagectomy
Oncology
Adenocarcinoma
business
Body mass index
Subjects
Details
- Language :
- English
- ISSN :
- 10689265
- Volume :
- 29
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Annals of surgical oncology
- Accession number :
- edsair.doi.dedup.....24b3e0f18b809901ab7c989085182259