Risk factors for postoperative anastomotic leakage after repair of esophageal atresia: a retrospective nationwide database study
Purpose Postoperative anastomotic leakage is the most frequent short-term complication of esophageal atresia repair in neonates. We conducted this study using a nationwide surgical database in Japan to identify the risk factors for anastomotic leakage in neonates undergoing esophageal atresia repair...
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| Veröffentlicht in: | Surgery today (Tokyo, Japan) Japan), 2023-11, Vol.53 (11), p.1269-1274 |
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| creator | Ishimaru, Tetsuya Shinjo, Daisuke Fujiogi, Michimasa Michihata, Nobuaki Morita, Kaori Hayashi, Kentaro Tachimori, Hisateru Kawashima, Hiroshi Fujishiro, Jun Yasunaga, Hideo |
| description | Purpose
Postoperative anastomotic leakage is the most frequent short-term complication of esophageal atresia repair in neonates. We conducted this study using a nationwide surgical database in Japan to identify the risk factors for anastomotic leakage in neonates undergoing esophageal atresia repair.
Methods
Neonates diagnosed with esophageal atresia between 2015 and 2019 were identified in the National Clinical Database. Postoperative anastomotic leakage was compared among patients to identify the potential risk factors, using univariate analysis. Multivariable logistic regression analysis included sex, gestational age, thoracoscopic repair, staged repair, and procedure time as independent variables.
Results
We identified 667 patients, with an overall leakage incidence of 7.8% (
n
= 52). Anastomotic leakage was more likely in patients who underwent staged repairs than in those who did not (21.2% vs. 5.2%, respectively) and in patients with a procedure time > 3.5 h than in those with a procedure time |
| doi_str_mv | 10.1007/s00595-023-02682-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2796161213</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2796161213</sourcerecordid><originalsourceid>FETCH-LOGICAL-c388t-37cc36972a2fbfe4f4a67ef2733522a7801cc4a5c564f80924da75cfdfc971a93</originalsourceid><addsrcrecordid>eNp9kM1u1TAQRi0EoreFF2CBvGSTMraTOGaHqvIjVUJCsLbmOuOSNjcOHgfUHY-O6S0sWViW_X1zpDlCvFBwrgDsawboXNeANvX0g27gkdip1vSNHpR5LHbgWtUo7dSJOGW-AdDtAPBUnBgLyg6924lfnye-lRFDSZllTFmuiUtaKWOZfpDEBevzkMoU5Ex4i9f1LxbKMtOKU5YpSuK0fqsBzhJLJp7wjcSal5x4pXDPWSouLT-nkeSIBffIJLls490z8STizPT84T4TX99dfrn40Fx9ev_x4u1VE8wwlMbYEEzvrEYd95Ha2GJvKWprTKc12gFUCC12oevbOIDT7Yi2C3GMwVmFzpyJV0fumtP3jbj4w8SB5hkXSht7bV2veqWVqVV9rIa6AGeKfs3TAfOdV-D_mPdH876a9_fmPdShlw_8bX-g8d_IX9W1YI4FrtFyTdnfpC0vdef_YX8D5OmRzw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2796161213</pqid></control><display><type>article</type><title>Risk factors for postoperative anastomotic leakage after repair of esophageal atresia: a retrospective nationwide database study</title><source>SpringerLink Journals</source><creator>Ishimaru, Tetsuya ; Shinjo, Daisuke ; Fujiogi, Michimasa ; Michihata, Nobuaki ; Morita, Kaori ; Hayashi, Kentaro ; Tachimori, Hisateru ; Kawashima, Hiroshi ; Fujishiro, Jun ; Yasunaga, Hideo</creator><creatorcontrib>Ishimaru, Tetsuya ; Shinjo, Daisuke ; Fujiogi, Michimasa ; Michihata, Nobuaki ; Morita, Kaori ; Hayashi, Kentaro ; Tachimori, Hisateru ; Kawashima, Hiroshi ; Fujishiro, Jun ; Yasunaga, Hideo</creatorcontrib><description>Purpose
Postoperative anastomotic leakage is the most frequent short-term complication of esophageal atresia repair in neonates. We conducted this study using a nationwide surgical database in Japan to identify the risk factors for anastomotic leakage in neonates undergoing esophageal atresia repair.
Methods
Neonates diagnosed with esophageal atresia between 2015 and 2019 were identified in the National Clinical Database. Postoperative anastomotic leakage was compared among patients to identify the potential risk factors, using univariate analysis. Multivariable logistic regression analysis included sex, gestational age, thoracoscopic repair, staged repair, and procedure time as independent variables.
Results
We identified 667 patients, with an overall leakage incidence of 7.8% (
n
= 52). Anastomotic leakage was more likely in patients who underwent staged repairs than in those who did not (21.2% vs. 5.2%, respectively) and in patients with a procedure time > 3.5 h than in those with a procedure time < 3.5 h (12.6% vs. 3.0%, respectively;
p
< 0.001). Multivariable logistic regression analysis identified staged repair (odds ratio [OR] 4.89, 95% confidence interval [CI] 2.22–10.16,
p
< 0.001) and a longer procedure time (OR 4.65, 95% CI 2.38–9.95,
p
< 0.001) as risk factors associated with postoperative leakage.
Conclusion
Staged procedures and long operative times are associated with postoperative anastomotic leakage, suggesting that leakage is more likely after complex esophageal atresia repair and that such patients require refined treatment strategies.</description><identifier>ISSN: 0941-1291</identifier><identifier>EISSN: 1436-2813</identifier><identifier>DOI: 10.1007/s00595-023-02682-0</identifier><identifier>PMID: 37017869</identifier><language>eng</language><publisher>Singapore: Springer Nature Singapore</publisher><subject>Medicine ; Medicine & Public Health ; Original Article ; Surgery ; Surgical Oncology</subject><ispartof>Surgery today (Tokyo, Japan), 2023-11, Vol.53 (11), p.1269-1274</ispartof><rights>The Author(s) under exclusive licence to Springer Nature Singapore Pte Ltd. 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s) under exclusive licence to Springer Nature Singapore Pte Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c388t-37cc36972a2fbfe4f4a67ef2733522a7801cc4a5c564f80924da75cfdfc971a93</cites><orcidid>0000-0002-2908-7416</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00595-023-02682-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00595-023-02682-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37017869$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ishimaru, Tetsuya</creatorcontrib><creatorcontrib>Shinjo, Daisuke</creatorcontrib><creatorcontrib>Fujiogi, Michimasa</creatorcontrib><creatorcontrib>Michihata, Nobuaki</creatorcontrib><creatorcontrib>Morita, Kaori</creatorcontrib><creatorcontrib>Hayashi, Kentaro</creatorcontrib><creatorcontrib>Tachimori, Hisateru</creatorcontrib><creatorcontrib>Kawashima, Hiroshi</creatorcontrib><creatorcontrib>Fujishiro, Jun</creatorcontrib><creatorcontrib>Yasunaga, Hideo</creatorcontrib><title>Risk factors for postoperative anastomotic leakage after repair of esophageal atresia: a retrospective nationwide database study</title><title>Surgery today (Tokyo, Japan)</title><addtitle>Surg Today</addtitle><addtitle>Surg Today</addtitle><description>Purpose
Postoperative anastomotic leakage is the most frequent short-term complication of esophageal atresia repair in neonates. We conducted this study using a nationwide surgical database in Japan to identify the risk factors for anastomotic leakage in neonates undergoing esophageal atresia repair.
Methods
Neonates diagnosed with esophageal atresia between 2015 and 2019 were identified in the National Clinical Database. Postoperative anastomotic leakage was compared among patients to identify the potential risk factors, using univariate analysis. Multivariable logistic regression analysis included sex, gestational age, thoracoscopic repair, staged repair, and procedure time as independent variables.
Results
We identified 667 patients, with an overall leakage incidence of 7.8% (
n
= 52). Anastomotic leakage was more likely in patients who underwent staged repairs than in those who did not (21.2% vs. 5.2%, respectively) and in patients with a procedure time > 3.5 h than in those with a procedure time < 3.5 h (12.6% vs. 3.0%, respectively;
p
< 0.001). Multivariable logistic regression analysis identified staged repair (odds ratio [OR] 4.89, 95% confidence interval [CI] 2.22–10.16,
p
< 0.001) and a longer procedure time (OR 4.65, 95% CI 2.38–9.95,
p
< 0.001) as risk factors associated with postoperative leakage.
Conclusion
Staged procedures and long operative times are associated with postoperative anastomotic leakage, suggesting that leakage is more likely after complex esophageal atresia repair and that such patients require refined treatment strategies.</description><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Article</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><issn>0941-1291</issn><issn>1436-2813</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9kM1u1TAQRi0EoreFF2CBvGSTMraTOGaHqvIjVUJCsLbmOuOSNjcOHgfUHY-O6S0sWViW_X1zpDlCvFBwrgDsawboXNeANvX0g27gkdip1vSNHpR5LHbgWtUo7dSJOGW-AdDtAPBUnBgLyg6924lfnye-lRFDSZllTFmuiUtaKWOZfpDEBevzkMoU5Ex4i9f1LxbKMtOKU5YpSuK0fqsBzhJLJp7wjcSal5x4pXDPWSouLT-nkeSIBffIJLls490z8STizPT84T4TX99dfrn40Fx9ev_x4u1VE8wwlMbYEEzvrEYd95Ha2GJvKWprTKc12gFUCC12oevbOIDT7Yi2C3GMwVmFzpyJV0fumtP3jbj4w8SB5hkXSht7bV2veqWVqVV9rIa6AGeKfs3TAfOdV-D_mPdH876a9_fmPdShlw_8bX-g8d_IX9W1YI4FrtFyTdnfpC0vdef_YX8D5OmRzw</recordid><startdate>20231101</startdate><enddate>20231101</enddate><creator>Ishimaru, Tetsuya</creator><creator>Shinjo, Daisuke</creator><creator>Fujiogi, Michimasa</creator><creator>Michihata, Nobuaki</creator><creator>Morita, Kaori</creator><creator>Hayashi, Kentaro</creator><creator>Tachimori, Hisateru</creator><creator>Kawashima, Hiroshi</creator><creator>Fujishiro, Jun</creator><creator>Yasunaga, Hideo</creator><general>Springer Nature Singapore</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2908-7416</orcidid></search><sort><creationdate>20231101</creationdate><title>Risk factors for postoperative anastomotic leakage after repair of esophageal atresia: a retrospective nationwide database study</title><author>Ishimaru, Tetsuya ; Shinjo, Daisuke ; Fujiogi, Michimasa ; Michihata, Nobuaki ; Morita, Kaori ; Hayashi, Kentaro ; Tachimori, Hisateru ; Kawashima, Hiroshi ; Fujishiro, Jun ; Yasunaga, Hideo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c388t-37cc36972a2fbfe4f4a67ef2733522a7801cc4a5c564f80924da75cfdfc971a93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Article</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ishimaru, Tetsuya</creatorcontrib><creatorcontrib>Shinjo, Daisuke</creatorcontrib><creatorcontrib>Fujiogi, Michimasa</creatorcontrib><creatorcontrib>Michihata, Nobuaki</creatorcontrib><creatorcontrib>Morita, Kaori</creatorcontrib><creatorcontrib>Hayashi, Kentaro</creatorcontrib><creatorcontrib>Tachimori, Hisateru</creatorcontrib><creatorcontrib>Kawashima, Hiroshi</creatorcontrib><creatorcontrib>Fujishiro, Jun</creatorcontrib><creatorcontrib>Yasunaga, Hideo</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Surgery today (Tokyo, Japan)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ishimaru, Tetsuya</au><au>Shinjo, Daisuke</au><au>Fujiogi, Michimasa</au><au>Michihata, Nobuaki</au><au>Morita, Kaori</au><au>Hayashi, Kentaro</au><au>Tachimori, Hisateru</au><au>Kawashima, Hiroshi</au><au>Fujishiro, Jun</au><au>Yasunaga, Hideo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk factors for postoperative anastomotic leakage after repair of esophageal atresia: a retrospective nationwide database study</atitle><jtitle>Surgery today (Tokyo, Japan)</jtitle><stitle>Surg Today</stitle><addtitle>Surg Today</addtitle><date>2023-11-01</date><risdate>2023</risdate><volume>53</volume><issue>11</issue><spage>1269</spage><epage>1274</epage><pages>1269-1274</pages><issn>0941-1291</issn><eissn>1436-2813</eissn><abstract>Purpose
Postoperative anastomotic leakage is the most frequent short-term complication of esophageal atresia repair in neonates. We conducted this study using a nationwide surgical database in Japan to identify the risk factors for anastomotic leakage in neonates undergoing esophageal atresia repair.
Methods
Neonates diagnosed with esophageal atresia between 2015 and 2019 were identified in the National Clinical Database. Postoperative anastomotic leakage was compared among patients to identify the potential risk factors, using univariate analysis. Multivariable logistic regression analysis included sex, gestational age, thoracoscopic repair, staged repair, and procedure time as independent variables.
Results
We identified 667 patients, with an overall leakage incidence of 7.8% (
n
= 52). Anastomotic leakage was more likely in patients who underwent staged repairs than in those who did not (21.2% vs. 5.2%, respectively) and in patients with a procedure time > 3.5 h than in those with a procedure time < 3.5 h (12.6% vs. 3.0%, respectively;
p
< 0.001). Multivariable logistic regression analysis identified staged repair (odds ratio [OR] 4.89, 95% confidence interval [CI] 2.22–10.16,
p
< 0.001) and a longer procedure time (OR 4.65, 95% CI 2.38–9.95,
p
< 0.001) as risk factors associated with postoperative leakage.
Conclusion
Staged procedures and long operative times are associated with postoperative anastomotic leakage, suggesting that leakage is more likely after complex esophageal atresia repair and that such patients require refined treatment strategies.</abstract><cop>Singapore</cop><pub>Springer Nature Singapore</pub><pmid>37017869</pmid><doi>10.1007/s00595-023-02682-0</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-2908-7416</orcidid></addata></record> |
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| subjects | Medicine Medicine & Public Health Original Article Surgery Surgical Oncology |
| title | Risk factors for postoperative anastomotic leakage after repair of esophageal atresia: a retrospective nationwide database study |
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