Risk Factor Analysis for Developing Major Complications Following Esophageal Surgery-A Two-Center Study

Esophagectomy carries a high risk of morbidity and mortality compared to other major surgeries. With the aim of creating an easy-to-use clinical preoperative risk assessment tool and to validate previously described risk factors for major complications following surgery, esophagectomies at two terti...

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Bibliographic Details
Published in:Journal of clinical medicine 2024-02, Vol.13 (4), p.1137
Main Authors: Stüben, Björn-Ole, Plitzko, Gabriel Andreas, Stern, Louisa, Schmeding, Rainer, Karstens, Karl-Frederick, Reeh, Matthias, Treckmann, Jürgen Walter, Izbicki, Jakob Robert, Saner, Fuat Hakan, Neuhaus, Jan Peter, Tachezy, Michael, Hoyer, Dieter Paul
Format: Article
Language:English
Subjects:
Alcohol
Alcohol abuse
Cardiovascular disease
Chemotherapy
Chronic obstructive pulmonary disease
Complications
Endoscopy
Esophageal cancer
Esophagus
Laparoscopy
Laparotomy
Mortality
Multivariate analysis
Ostomy
Patients
Regression analysis
Risk factors
Software
Statistical analysis
Surgery
Surgical anastomosis
Surgical outcomes
Thoracic surgery
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Summary:Esophagectomy carries a high risk of morbidity and mortality compared to other major surgeries. With the aim of creating an easy-to-use clinical preoperative risk assessment tool and to validate previously described risk factors for major complications following surgery, esophagectomies at two tertiary medical centers were analyzed. A total of 450 patients who underwent esophagectomy for esophageal carcinoma at the University Medical Centre, Hamburg, or at the Medical Center University Duisburg-Essen, Germany (January 2008 to January 2020) were retrospectively analyzed. Epidemiological and perioperative data were analyzed to identify the risk factors that impact major complication rates. The primary endpoint of this study was to determine the incidence of major complications. The mean age of the patients was 63 years with a bimodal distribution. There was a male predominance across the cohort (81% vs. 19%, respectively). Alcohol abuse ( = 0.0341), chronic obstructive pulmonary disease ( = 0.0264), and cardiac comorbidity ( = 0.0367) were associated with a significantly higher risk of major complications in the multivariate analysis. Neoadjuvant chemotherapy significantly reduced the risk of major postoperative complications ( < 0.0001). Various patient-related risk factors increased the rate of major complications following esophagectomy. Patient-tailored prehabilitation programs before esophagectomy that focus on minimizing these risk factors may lead to better surgical outcomes and should be analyzed in further studies.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm13041137