The role of surgery type in postoperative atrial fibrillation and in-hospital mortality in esophageal cancer patients with preserved left ventricular ejection fraction

• Published in: World journal of surgical oncology 2020-09, Vol.18 (1), p.244-244, Article 244
• Main Authors: Chen, Laite, Zhang, Lu, Shi, Lu, Fu, Guosheng, Jiang, Chenyang
• Format: Article
• Language: English
• Subjects: Age; Atrial fibrillation; Atrial Fibrillation - etiology; Body mass; Body mass index; Body size; Cancer; Cardiac arrhythmia; Care and treatment; China; Complications; Complications and side effects; Datasets; Diuretics; Ejection fraction; Esophageal cancer; Esophageal Neoplasms - surgery; Esophageal surgery; Esophagectomy; Esophagectomy - adverse effects; Esophagus; Fibrillation; Forecasts and trends; Heart; Hospital Mortality; Humans; Hypertension; Kidneys; Laparoscopy; Lymphatic system; Minimally invasive surgery; Minimally Invasive Surgical Procedures; Mortality; Ostomy; Patients; Pneumonia; Postoperative atrial fibrillation; Postoperative Complications; Postoperative period; Prognosis; Regression models; Retrospective Studies; Risk; Risk factors; Sensitivity analysis; Sepsis; Statistical analysis; Stroke Volume; Surgery; Trauma; Treatment Outcome; Ventricle; Ventricular Function, Left
• ISSN: 1477-7819; 1477-7819
• DOI: 10.1186/s12957-020-02011-6

Postoperative atrial fibrillation (POAF) is one of the most common complications of esophagectomy, which may extend the inpatient hospital stay. Minimally invasive esophagectomy (MIE) has been increasingly used in clinical practice; however, its POAF risk and short-term mortality remain unclear. This study aimed to examine the POAF risk and in-hospital mortality rate between patients receiving MIE and open esophagectomy (OE). Esophageal cancer patients who underwent MIE or OE from a retrospective cohort study were evaluated. A multivariate logistic regression model was built to assess the associations between esophagectomy (MIE vs. OE) and various outcomes (POAF, in-hospital mortality). Covariates included age, sex, body mass index, neoadjuvant therapy, tumor stage, surgery incision type, comorbidities, cardia conditions, peri-operative medication, and complications. Of the 484 patients with esophageal cancer, 63 received MIE. A total of 53 patients developed POAF. Compared to patients receiving OE, MIE patients had 81% reduced odds of POAF (adjusted odds ratio [aOR] 0.185, 95% CI 0.039-0.887, P = 0.035). No statistically significant association was found for in-hospital mortality (aOR 0.709, 95% CI 0.114-4.409, P = 0.712). MIE is associated with a lower risk of POAF, compared to traditional surgery. No significant short-term survival benefit was found for MIE.