Case-control study on related risk factors of aortic-esophageal fistula after esophageal carcinoma operation / 重庆医学

ABSTRACT

Objective To explore the related risk factors of aortic esophageal fistula (AEF) after esophageal carcinoma operation.Methods According to the design of case-control study and matching proportion of 13,18 cases of AEF after esophageal carcinoma operation treated in the thoracic surgery department of Daping Hospital of Third Military Medical University from 2000 to 2015 served as the observation group,and contemporaneous 54 cases of esophageal carcinoma operation,who had approximate basic diseases or risk factors,were selected as the control group,18 pairs were formed.The risk factors possessed by the observation group before disease onset such as age,sex,tumor TNM stage and tumor location served as the matching variables.The non-matching variables including operation time,preoperative body mass index (BMI),amount of intraoperative hemorrhage,preoperative LDL level,anastomosis mode,postoperative pulmonary complications,postoperative arrhythmia,preoperative hypertension,preoperative diabetes and number of removed lymph nodes were performed the case-control study.Results The univariate Logistic analysis preliminarily screened out 5 risk factors,including preoperative obesity,preoperative LDL level,postoperative pulmonary complications,anstomosis mode and number of removed lymph nodes,the difference in other factors was not statistically significant (P＞ 0.05).The multivariate non-conditional Logistic stepwise regression analysis revealed that preoperative obesity (OR =8.63,95 ％ CI=1.35-17.60),preoperative LDL level (OR =0.81,95 ％ CI =0.23-0.98) and the number of intraoperatively removed lymph nodes (OR =0.32,95 ％ CI =0.14-0.59) had statistical differences between the observation group and control group,but the difference in other factors had no statistical significance.Conclusion Preoperative obesity,preoperative LDL level and number of removed lymph nodes might be the risk factors for AEF occurrence after esophageal carcinoma operation.