Analysis of the risk factors of anastomotic fistula after total endoscopic McKeown radical resection for esophageal cancer

ObjectiveTo explore the risk factors of anastomotic fistula after total endoscopic McKeown technique for esophageal cancer.

MethodsThe clinical data of 160 patients with esophageal cancer treated with total endoscopic McKeown technique were selected.The correlation between postoperative anastomotic fistula and gender, age, drinking history, smoking history, diabetes mellitus history, hypertension history, body mass index, tumor diameter, tumor location, preoperative radiotherapy and chemotherapy, operation time, anastomotic mode, making tubular stomach or not, embedding anastomotic site or not, suspending anastomotic site or not, serum albumin content on the third day after, postoperative pulmonary infection, pathological types was analyzed by univariate analysis.The independent risk factors of anastomotic fistula after operation for esophageal cancer were analyzed by multivariate logistic regression analysis.

ResultsAmong the 160 esophageal cancer cases, 31 cases had anastomotic fistula, which disappeared after conservative treatment; anastomotic stenosis occurred in 14 cases, and all improved after balloon dilatation; no stent implantation and death cases were found.Univariate analysis showed that the incidence of anastomotic fistula was higher in patients with tumor location of upper segment, no preoperative radiotherapy and chemotherapy, pulmonary infection and serum albumin < 30 g/L on the third day after operation (P < 0.05 to P < 0.01).Multivariate logistic regression analysis showed that serum albumin < 30 g/L on the third day after operation and postoperative pulmonary infection were the independent risk factors for anastomotic fistula after esophageal cancer operation (P < 0.05).

ConclusionsPostoperative serum content of albumin content < 30 g/L and postoperative pulmonary infection are the independent risk factors for anastomotic fistula after total endoscopic McKeown radical resection for esophageal cancer.The occurrence of anastomotic fistula can be effectively reduced by improving nutritional status and controlling pulmonary infection.