Vascular calcification does not predict anastomotic leak or conduit necrosis following oesophagectomy

作     者：Benjamin J Jefferies Emily Evans James Bundred James Hodson John L Whiting Colm Forde Ewen A Griffiths 

作者机构：College of Medical and Dental SciencesUniversity of BirminghamBirmingham B15 2TTUnited Kingdom Department of RadiologyUniversity Hospitals Birmingham NHS Foundation TrustBirmingham B15 2WBUnited Kingdom Institute of Translational MedicineUniversity Hospitals Birmingham NHS Foundation TrustBirmingham B15 2TTUnited Kingdom Department of Upper Gastrointestinal SurgeryUniversity Hospitals Birmingham NHS Foundation TrustBirmingham B15 2THUnited Kingdom Institute of Cancer and Genomic SciencesUniversity of BirminghamBirmingham B15 2TTUnited Kingdom 

出 版 物：《World Journal of Gastrointestinal Surgery》 (世界胃肠外科杂志（英文版）（电子版）)

年 卷 期：2019年第11卷第7期

页      面：308-321页

核心收录：

学科分类：10[医学] 

基　　金：Arthur Thompson Trust 

主　　题：Oesophagectomy Anastomotic leak Gastric conduit necrosis Calcification Computed tomography Ischaemia 

摘      要：BACKGROUND Anastomotic leaks(AL)and gastric conduit necrosis(CN)are serious complications following *** studies have suggested that vascular calcification may be associated with an increased AL rate,but this has not been validated in a United Kingdom *** To investigate whether vascular calcification identified on the pre-operative computed tomography(CT)scan is predictive of AL or *** Routine pre-operative CT scans of 414 patients who underwent oesophagectomy for malignancy with oesophagogastric anastomosis at the Queen Elizabeth Hospital Birmingham between 2006 and 2018 were retrospectively *** of the proximal aorta,distal aorta,coeliac trunk and branches of the coeliac trunk was scored by two *** relationship between these calcification scores and occurrence of AL and CN was then *** Esophagectomy Complications Consensus Group definition of AL and CN was *** Complication data were available in n=411 patients,of whom 16.7%developed either AL(15.8%)or CN(3.4%).Rates of AL were significantly higher in female patients,at 23.0%,compared to 13.9%in males(P=0.047).CN was significantly more common in females,(8.0%vs 2.2%,P=0.014),patients with diabetes(10.6%vs 2.5%,P=0.014),a history of smoking(10.3%vs 2.3%,P=0.008),and a higher American Society of Anaesthesiologists grade(P=0.024).Out of the 14 conduit necroses,only 4 occurred without a concomitant *** statistically significant association was found between calcification of any of the vessels studied and either of these *** analyses were then performed to identify whether a combination of the calcification scores could be identified that would be significantly predictive of any of the ***,the stepwise approach did not select any factors for inclusion in the final *** analysis was repeated for composite outcomes of those patients with either AL or CN(n=69,16.7%)and for those with both AL and CN(n=10,2.