Transthoracic approach is associated with increased incidence of atrial fibrillation after esophageal resection
Aim Atrial fibrillation (AF) has been associated with higher morbidity after esophagectomy. The objective of this study is to identify the surgical risk factors associated with new-onset atrial fibrillation after esophagectomy. Methods After Institutional Review Board approval, a prospectively maint...
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| Veröffentlicht in: | Surgical endoscopy 2015-07, Vol.29 (7), p.2039-2045 |
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| creator | Lohani, Kush R. Nandipati, Kalyana C. Rollins, Sarah E. Fetten, Katharina Lee, Tommy H. Pallati, Pradeep K. Yamamoto, Se Ryung Mittal, Sumeet K. |
| description | Aim
Atrial fibrillation (AF) has been associated with higher morbidity after esophagectomy. The objective of this study is to identify the surgical risk factors associated with new-onset atrial fibrillation after esophagectomy.
Methods
After Institutional Review Board approval, a prospectively maintained database was retrospectively queried to identify patients who underwent esophagectomy between 2003 and 2013. Data variables collected include pre-operative, intra-operative, and post-operative factors. Appropriate statistical analysis is performed utilizing Sigmaplot
®
version 12.3.
Results
From 2003 to 2013, 245 esophagectomies were performed at our institution, of these, 192 (147 males, mean age of 62 ± 11.12 years) were included in the final analysis and 53 were excluded [25 Roux-en-Y reconstruction (including three Merendino procedures), 20 had AF before surgery, and eight with staged esophagectomy]. Of 192 esophagectomies, 160 had malignancy (138 adenocarcinoma and 22 squamous cell carcinoma) and 106 (66.25 %) received neo-adjuvant therapy. Esophagectomies were performed with Ivor Lewis Mckeown approach in 78 patients [34 Minimally Invasive (MIE), 37 open, and 7 Hybrid], Ivor Lewis approach in 56 patients (31 MIE, 10 Open, 15 Hybrid) and Transhiatal approach in 58 patients (16 MIE and 42 Open). Gastric conduit was used in 185 patients and colonic conduit in seven patients. Overall 30-day or in-hospital mortality was 3.6 % (7/192). Forty-five (23.4 %) patients with esophagectomy developed new-onset AF. Median onset of AF was post-op day 3 (0–32). They were older (65.7 vs. 61.3,
p
= 0.021), with medical comorbidities (thyroid disorder, hyperlipidemia, and coronary artery disease;
p
|
| doi_str_mv | 10.1007/s00464-014-3908-9 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1690211020</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1690211020</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-18dd2be07ddcf5e3bc450e203128e9239c9f3d08022bb0967e8e113ed017b1ff3</originalsourceid><addsrcrecordid>eNp1kUtrWzEQhUVoSFy3P6CbIuimm5vMSPelZQl9QSCbZC10pVGsYF-5mmtK_31knJZS6EqP882ZkY4Q7xCuEGC4ZoC2bxvAttEGxsaciRW2WjVK4fhKrMBoaNRg2kvxmvkJKm6wuxCXqtM99u2wEvm-uJmXTS7OJy_dfl-y8xuZWDrm7JNbKMifaalXsy_kuB7rLgWaPckcpVtKclsZ01TSduuWlGfp4kJFEuf9xj1SVQsx-aP0RpxHt2V6-7KuxcOXz_c335rbu6_fbz7dNl4PamlwDEFNBEMIPnakJ992QAo0qpGM0sabqAOMoNQ0gekHGglRUwAcJoxRr8XHk299z48D8WJ3iT3VAWfKB7bYG1CIUC3X4sM_6FM-lLlOV6nRdJ0ZuyOFJ8qXzFwo2n1JO1d-WQR7TMOe0rA1DXtMw5pa8_7F-TDtKPyp-P39FVAngKs0P1L5q_V_XZ8B2JOWSg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1689559850</pqid></control><display><type>article</type><title>Transthoracic approach is associated with increased incidence of atrial fibrillation after esophageal resection</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Lohani, Kush R. ; Nandipati, Kalyana C. ; Rollins, Sarah E. ; Fetten, Katharina ; Lee, Tommy H. ; Pallati, Pradeep K. ; Yamamoto, Se Ryung ; Mittal, Sumeet K.</creator><creatorcontrib>Lohani, Kush R. ; Nandipati, Kalyana C. ; Rollins, Sarah E. ; Fetten, Katharina ; Lee, Tommy H. ; Pallati, Pradeep K. ; Yamamoto, Se Ryung ; Mittal, Sumeet K.</creatorcontrib><description>Aim
Atrial fibrillation (AF) has been associated with higher morbidity after esophagectomy. The objective of this study is to identify the surgical risk factors associated with new-onset atrial fibrillation after esophagectomy.
Methods
After Institutional Review Board approval, a prospectively maintained database was retrospectively queried to identify patients who underwent esophagectomy between 2003 and 2013. Data variables collected include pre-operative, intra-operative, and post-operative factors. Appropriate statistical analysis is performed utilizing Sigmaplot
®
version 12.3.
Results
From 2003 to 2013, 245 esophagectomies were performed at our institution, of these, 192 (147 males, mean age of 62 ± 11.12 years) were included in the final analysis and 53 were excluded [25 Roux-en-Y reconstruction (including three Merendino procedures), 20 had AF before surgery, and eight with staged esophagectomy]. Of 192 esophagectomies, 160 had malignancy (138 adenocarcinoma and 22 squamous cell carcinoma) and 106 (66.25 %) received neo-adjuvant therapy. Esophagectomies were performed with Ivor Lewis Mckeown approach in 78 patients [34 Minimally Invasive (MIE), 37 open, and 7 Hybrid], Ivor Lewis approach in 56 patients (31 MIE, 10 Open, 15 Hybrid) and Transhiatal approach in 58 patients (16 MIE and 42 Open). Gastric conduit was used in 185 patients and colonic conduit in seven patients. Overall 30-day or in-hospital mortality was 3.6 % (7/192). Forty-five (23.4 %) patients with esophagectomy developed new-onset AF. Median onset of AF was post-op day 3 (0–32). They were older (65.7 vs. 61.3,
p
= 0.021), with medical comorbidities (thyroid disorder, hyperlipidemia, and coronary artery disease;
p
< 0.05) and lower diffusion capacity on Pulmonary function test (80.16 vs. 87.74 %,
p
= 0.02) and stayed longer in hospital (19 vs. 14 days,
p
< 0.001) with severe post-operative complications (Clavien score ≥ III) (69 vs. 35.3 %,
p
< 0.001). Multiple logistic regression analysis showed transthoracic approach (OR = 3.71, CI = 1.23–11.17,
p
= 0.02) and thyroid disorder (OR = 6.29, CI = 1.54–25.65,
p
= 0.01), and severe post-op complications (OR = 3.34, CI = 1.20–9.28,
p
= 0.02) were significantly associated with the development of new-onset AF.
Conclusions
Transthoracic approach is an independent risk factor for the development of new-onset AF after esophagectomy. New-onset AF is associated with severe post-operative complications and longer hospital stay. Minimally invasive approach does not decrease the incidence of new-onset AF.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-014-3908-9</identifier><identifier>PMID: 25361647</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdominal Surgery ; Adenocarcinoma - surgery ; Age Factors ; Aged ; Atrial Fibrillation - epidemiology ; Carcinoma, Squamous Cell - surgery ; Cardiovascular disease ; Comorbidity ; Coronary Artery Disease - epidemiology ; Databases, Factual ; Esophageal Neoplasms - surgery ; Esophagectomy - methods ; Esophagus ; Female ; Gastroenterology ; Gynecology ; Hepatology ; Hospital Mortality ; Hospitals ; Humans ; Hyperlipidemias - epidemiology ; Incidence ; Laparoscopy - methods ; Logistic Models ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Minimally Invasive Surgical Procedures - methods ; Multivariate Analysis ; Ostomy ; Postoperative Complications - epidemiology ; Proctology ; Pulmonary Diffusing Capacity ; Regression analysis ; Retrospective Studies ; Risk Factors ; Surgery ; Thoracic surgery ; Thyroid Diseases - epidemiology ; Thyroid gland</subject><ispartof>Surgical endoscopy, 2015-07, Vol.29 (7), p.2039-2045</ispartof><rights>Springer Science+Business Media New York 2014</rights><rights>Springer Science+Business Media New York 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-18dd2be07ddcf5e3bc450e203128e9239c9f3d08022bb0967e8e113ed017b1ff3</citedby><cites>FETCH-LOGICAL-c372t-18dd2be07ddcf5e3bc450e203128e9239c9f3d08022bb0967e8e113ed017b1ff3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-014-3908-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-014-3908-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,777,781,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25361647$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lohani, Kush R.</creatorcontrib><creatorcontrib>Nandipati, Kalyana C.</creatorcontrib><creatorcontrib>Rollins, Sarah E.</creatorcontrib><creatorcontrib>Fetten, Katharina</creatorcontrib><creatorcontrib>Lee, Tommy H.</creatorcontrib><creatorcontrib>Pallati, Pradeep K.</creatorcontrib><creatorcontrib>Yamamoto, Se Ryung</creatorcontrib><creatorcontrib>Mittal, Sumeet K.</creatorcontrib><title>Transthoracic approach is associated with increased incidence of atrial fibrillation after esophageal resection</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Aim
Atrial fibrillation (AF) has been associated with higher morbidity after esophagectomy. The objective of this study is to identify the surgical risk factors associated with new-onset atrial fibrillation after esophagectomy.
Methods
After Institutional Review Board approval, a prospectively maintained database was retrospectively queried to identify patients who underwent esophagectomy between 2003 and 2013. Data variables collected include pre-operative, intra-operative, and post-operative factors. Appropriate statistical analysis is performed utilizing Sigmaplot
®
version 12.3.
Results
From 2003 to 2013, 245 esophagectomies were performed at our institution, of these, 192 (147 males, mean age of 62 ± 11.12 years) were included in the final analysis and 53 were excluded [25 Roux-en-Y reconstruction (including three Merendino procedures), 20 had AF before surgery, and eight with staged esophagectomy]. Of 192 esophagectomies, 160 had malignancy (138 adenocarcinoma and 22 squamous cell carcinoma) and 106 (66.25 %) received neo-adjuvant therapy. Esophagectomies were performed with Ivor Lewis Mckeown approach in 78 patients [34 Minimally Invasive (MIE), 37 open, and 7 Hybrid], Ivor Lewis approach in 56 patients (31 MIE, 10 Open, 15 Hybrid) and Transhiatal approach in 58 patients (16 MIE and 42 Open). Gastric conduit was used in 185 patients and colonic conduit in seven patients. Overall 30-day or in-hospital mortality was 3.6 % (7/192). Forty-five (23.4 %) patients with esophagectomy developed new-onset AF. Median onset of AF was post-op day 3 (0–32). They were older (65.7 vs. 61.3,
p
= 0.021), with medical comorbidities (thyroid disorder, hyperlipidemia, and coronary artery disease;
p
< 0.05) and lower diffusion capacity on Pulmonary function test (80.16 vs. 87.74 %,
p
= 0.02) and stayed longer in hospital (19 vs. 14 days,
p
< 0.001) with severe post-operative complications (Clavien score ≥ III) (69 vs. 35.3 %,
p
< 0.001). Multiple logistic regression analysis showed transthoracic approach (OR = 3.71, CI = 1.23–11.17,
p
= 0.02) and thyroid disorder (OR = 6.29, CI = 1.54–25.65,
p
= 0.01), and severe post-op complications (OR = 3.34, CI = 1.20–9.28,
p
= 0.02) were significantly associated with the development of new-onset AF.
Conclusions
Transthoracic approach is an independent risk factor for the development of new-onset AF after esophagectomy. New-onset AF is associated with severe post-operative complications and longer hospital stay. Minimally invasive approach does not decrease the incidence of new-onset AF.</description><subject>Abdominal Surgery</subject><subject>Adenocarcinoma - surgery</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Atrial Fibrillation - epidemiology</subject><subject>Carcinoma, Squamous Cell - surgery</subject><subject>Cardiovascular disease</subject><subject>Comorbidity</subject><subject>Coronary Artery Disease - epidemiology</subject><subject>Databases, Factual</subject><subject>Esophageal Neoplasms - surgery</subject><subject>Esophagectomy - methods</subject><subject>Esophagus</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Hospital Mortality</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hyperlipidemias - epidemiology</subject><subject>Incidence</subject><subject>Laparoscopy - methods</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Minimally Invasive Surgical Procedures - methods</subject><subject>Multivariate Analysis</subject><subject>Ostomy</subject><subject>Postoperative Complications - epidemiology</subject><subject>Proctology</subject><subject>Pulmonary Diffusing Capacity</subject><subject>Regression analysis</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Surgery</subject><subject>Thoracic surgery</subject><subject>Thyroid Diseases - epidemiology</subject><subject>Thyroid gland</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kUtrWzEQhUVoSFy3P6CbIuimm5vMSPelZQl9QSCbZC10pVGsYF-5mmtK_31knJZS6EqP882ZkY4Q7xCuEGC4ZoC2bxvAttEGxsaciRW2WjVK4fhKrMBoaNRg2kvxmvkJKm6wuxCXqtM99u2wEvm-uJmXTS7OJy_dfl-y8xuZWDrm7JNbKMifaalXsy_kuB7rLgWaPckcpVtKclsZ01TSduuWlGfp4kJFEuf9xj1SVQsx-aP0RpxHt2V6-7KuxcOXz_c335rbu6_fbz7dNl4PamlwDEFNBEMIPnakJ992QAo0qpGM0sabqAOMoNQ0gekHGglRUwAcJoxRr8XHk299z48D8WJ3iT3VAWfKB7bYG1CIUC3X4sM_6FM-lLlOV6nRdJ0ZuyOFJ8qXzFwo2n1JO1d-WQR7TMOe0rA1DXtMw5pa8_7F-TDtKPyp-P39FVAngKs0P1L5q_V_XZ8B2JOWSg</recordid><startdate>20150701</startdate><enddate>20150701</enddate><creator>Lohani, Kush R.</creator><creator>Nandipati, Kalyana C.</creator><creator>Rollins, Sarah E.</creator><creator>Fetten, Katharina</creator><creator>Lee, Tommy H.</creator><creator>Pallati, Pradeep K.</creator><creator>Yamamoto, Se Ryung</creator><creator>Mittal, Sumeet K.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20150701</creationdate><title>Transthoracic approach is associated with increased incidence of atrial fibrillation after esophageal resection</title><author>Lohani, Kush R. ; Nandipati, Kalyana C. ; Rollins, Sarah E. ; Fetten, Katharina ; Lee, Tommy H. ; Pallati, Pradeep K. ; Yamamoto, Se Ryung ; Mittal, Sumeet K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-18dd2be07ddcf5e3bc450e203128e9239c9f3d08022bb0967e8e113ed017b1ff3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Abdominal Surgery</topic><topic>Adenocarcinoma - surgery</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Atrial Fibrillation - epidemiology</topic><topic>Carcinoma, Squamous Cell - surgery</topic><topic>Cardiovascular disease</topic><topic>Comorbidity</topic><topic>Coronary Artery Disease - epidemiology</topic><topic>Databases, Factual</topic><topic>Esophageal Neoplasms - surgery</topic><topic>Esophagectomy - methods</topic><topic>Esophagus</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Hospital Mortality</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Hyperlipidemias - epidemiology</topic><topic>Incidence</topic><topic>Laparoscopy - methods</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Minimally Invasive Surgical Procedures - methods</topic><topic>Multivariate Analysis</topic><topic>Ostomy</topic><topic>Postoperative Complications - epidemiology</topic><topic>Proctology</topic><topic>Pulmonary Diffusing Capacity</topic><topic>Regression analysis</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Surgery</topic><topic>Thoracic surgery</topic><topic>Thyroid Diseases - epidemiology</topic><topic>Thyroid gland</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lohani, Kush R.</creatorcontrib><creatorcontrib>Nandipati, Kalyana C.</creatorcontrib><creatorcontrib>Rollins, Sarah E.</creatorcontrib><creatorcontrib>Fetten, Katharina</creatorcontrib><creatorcontrib>Lee, Tommy H.</creatorcontrib><creatorcontrib>Pallati, Pradeep K.</creatorcontrib><creatorcontrib>Yamamoto, Se Ryung</creatorcontrib><creatorcontrib>Mittal, Sumeet K.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lohani, Kush R.</au><au>Nandipati, Kalyana C.</au><au>Rollins, Sarah E.</au><au>Fetten, Katharina</au><au>Lee, Tommy H.</au><au>Pallati, Pradeep K.</au><au>Yamamoto, Se Ryung</au><au>Mittal, Sumeet K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Transthoracic approach is associated with increased incidence of atrial fibrillation after esophageal resection</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2015-07-01</date><risdate>2015</risdate><volume>29</volume><issue>7</issue><spage>2039</spage><epage>2045</epage><pages>2039-2045</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract>Aim
Atrial fibrillation (AF) has been associated with higher morbidity after esophagectomy. The objective of this study is to identify the surgical risk factors associated with new-onset atrial fibrillation after esophagectomy.
Methods
After Institutional Review Board approval, a prospectively maintained database was retrospectively queried to identify patients who underwent esophagectomy between 2003 and 2013. Data variables collected include pre-operative, intra-operative, and post-operative factors. Appropriate statistical analysis is performed utilizing Sigmaplot
®
version 12.3.
Results
From 2003 to 2013, 245 esophagectomies were performed at our institution, of these, 192 (147 males, mean age of 62 ± 11.12 years) were included in the final analysis and 53 were excluded [25 Roux-en-Y reconstruction (including three Merendino procedures), 20 had AF before surgery, and eight with staged esophagectomy]. Of 192 esophagectomies, 160 had malignancy (138 adenocarcinoma and 22 squamous cell carcinoma) and 106 (66.25 %) received neo-adjuvant therapy. Esophagectomies were performed with Ivor Lewis Mckeown approach in 78 patients [34 Minimally Invasive (MIE), 37 open, and 7 Hybrid], Ivor Lewis approach in 56 patients (31 MIE, 10 Open, 15 Hybrid) and Transhiatal approach in 58 patients (16 MIE and 42 Open). Gastric conduit was used in 185 patients and colonic conduit in seven patients. Overall 30-day or in-hospital mortality was 3.6 % (7/192). Forty-five (23.4 %) patients with esophagectomy developed new-onset AF. Median onset of AF was post-op day 3 (0–32). They were older (65.7 vs. 61.3,
p
= 0.021), with medical comorbidities (thyroid disorder, hyperlipidemia, and coronary artery disease;
p
< 0.05) and lower diffusion capacity on Pulmonary function test (80.16 vs. 87.74 %,
p
= 0.02) and stayed longer in hospital (19 vs. 14 days,
p
< 0.001) with severe post-operative complications (Clavien score ≥ III) (69 vs. 35.3 %,
p
< 0.001). Multiple logistic regression analysis showed transthoracic approach (OR = 3.71, CI = 1.23–11.17,
p
= 0.02) and thyroid disorder (OR = 6.29, CI = 1.54–25.65,
p
= 0.01), and severe post-op complications (OR = 3.34, CI = 1.20–9.28,
p
= 0.02) were significantly associated with the development of new-onset AF.
Conclusions
Transthoracic approach is an independent risk factor for the development of new-onset AF after esophagectomy. New-onset AF is associated with severe post-operative complications and longer hospital stay. Minimally invasive approach does not decrease the incidence of new-onset AF.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>25361647</pmid><doi>10.1007/s00464-014-3908-9</doi><tpages>7</tpages></addata></record> |
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| ispartof | Surgical endoscopy, 2015-07, Vol.29 (7), p.2039-2045 |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Abdominal Surgery Adenocarcinoma - surgery Age Factors Aged Atrial Fibrillation - epidemiology Carcinoma, Squamous Cell - surgery Cardiovascular disease Comorbidity Coronary Artery Disease - epidemiology Databases, Factual Esophageal Neoplasms - surgery Esophagectomy - methods Esophagus Female Gastroenterology Gynecology Hepatology Hospital Mortality Hospitals Humans Hyperlipidemias - epidemiology Incidence Laparoscopy - methods Logistic Models Male Medicine Medicine & Public Health Middle Aged Minimally Invasive Surgical Procedures - methods Multivariate Analysis Ostomy Postoperative Complications - epidemiology Proctology Pulmonary Diffusing Capacity Regression analysis Retrospective Studies Risk Factors Surgery Thoracic surgery Thyroid Diseases - epidemiology Thyroid gland |
| title | Transthoracic approach is associated with increased incidence of atrial fibrillation after esophageal resection |
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