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van Kooten RT, Voeten DM, Steyerberg EW, et al. Patient-Related Prognostic Factors for Anastomotic Leakage, Major Complications, and Short-Term Mortality Following Esophagectomy for Cancer: A Systematic Review and Meta-Analyses. Ann Surg Oncol. 2021;doi: 10.1245/s10434-021-10734-3.
van Kooten, R. T., Voeten, D. M., Steyerberg, E. W., Hartgrink, H. H., van Berge Henegouwen, M. I., van Hillegersberg, R., Tollenaar, R. A. E. M., & Wouters, M. W. J. M. (2021). Patient-Related Prognostic Factors for Anastomotic Leakage, Major Complications, and Short-Term Mortality Following Esophagectomy for Cancer: A Systematic Review and Meta-Analyses. Annals of surgical oncology, . https://doi.org/10.1245/s10434-021-10734-3
van Kooten, Robert T, et al. "Patient-Related Prognostic Factors for Anastomotic Leakage, Major Complications, and Short-Term Mortality Following Esophagectomy for Cancer: A Systematic Review and Meta-Analyses." Annals of surgical oncology vol. (2021). doi: https://doi.org/10.1245/s10434-021-10734-3
van Kooten RT, Voeten DM, Steyerberg EW, Hartgrink HH, van Berge Henegouwen MI, van Hillegersberg R, Tollenaar RAEM, Wouters MWJM. Patient-Related Prognostic Factors for Anastomotic Leakage, Major Complications, and Short-Term Mortality Following Esophagectomy for Cancer: A Systematic Review and Meta-Analyses. Ann Surg Oncol. 2021 Sep 05; doi: 10.1245/s10434-021-10734-3. Epub 2021 Sep 05. PMID: 34482453.
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Ann Surg Oncol. 2021 Sep 05; doi: 10.1245/s10434-021-10734-3. Epub 2021 Sep 05.

Patient-Related Prognostic Factors for Anastomotic Leakage, Major Complications, and Short-Term Mortality Following Esophagectomy for Cancer: A Systematic Review and Meta-Analyses.

Annals of surgical oncology

Robert T van Kooten, Daan M Voeten, Ewout W Steyerberg, Henk H Hartgrink, Mark I van Berge Henegouwen, Richard van Hillegersberg, Rob A E M Tollenaar, Michel W J M Wouters

Affiliations

  1. Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands. [email protected].
  2. Department of Surgery, Amsterdam UMC, Cancer Center Amsterdam, University of Amsterdam, Amsterdam, the Netherlands.
  3. Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands.
  4. Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands.
  5. Department of Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.
  6. Department of Surgery, Dutch Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands.

PMID: 34482453 DOI: 10.1245/s10434-021-10734-3

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/m

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.

© 2021. The Author(s).

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