Risk Factor Analysis for Developing Major Complications Following Esophageal Surgery-A Two-Center Study

Area of Science:

• Surgical Oncology
• Thoracic Surgery
• Clinical Risk Assessment

Background:

• Esophagectomy is a high-risk procedure with significant morbidity and mortality.
• Previous risk factors for complications after esophagectomy require validation.
• Development of a user-friendly preoperative risk assessment tool is needed.

Purpose of the Study:

• To identify preoperative risk factors for major complications following esophagectomy.
• To validate previously described risk factors for adverse outcomes.
• To assess the impact of neoadjuvant chemotherapy on complication rates.

Main Methods:

• Retrospective analysis of 450 patients undergoing esophagectomy for esophageal carcinoma.
• Data collected from two tertiary medical centers in Germany (2008-2020).
• Multivariate analysis to identify risk factors impacting major complication rates.

Main Results:

• Alcohol abuse, chronic obstructive pulmonary disease (COPD), and cardiac comorbidity were significantly associated with higher complication rates.
• Neoadjuvant chemotherapy demonstrated a significant reduction in major postoperative complications (p < 0.0001).
• Mean patient age was 63 years, with 81% males.

Conclusions:

• Patient-specific risk factors significantly increase the likelihood of major complications after esophagectomy.
• Prehabilitation programs targeting identified risk factors could improve surgical outcomes.
• Further studies are warranted to evaluate the efficacy of prehabilitation strategies.