ANASTOMOTIC LEAK IS NOT ASSOCIATED WITH DEVELOPMENT OF ATRIAL FIBRILLATION AFTER TRANSHIATAL ESOPHAGECTOMY
Shankar Logarajah*1, Shawn C. Cudworth2, Maitham A. Moslim1, Michael Jureller1, Houssam Osman1,2, D. Rohan Jeyarajah1,2
1Methodist Richardson Medical Center, Richardson, TX; 2Texas Christian University, Fort Worth, TX
Introduction
Atrial fibrillation has a reported incidence after esophagectomy of approximately 12-37%. The onset of atrial fibrillation, especially after a transhiatal esophagectomy (THE), has been associated with a clinically relevant leak. We sought to determine whether this association was still true with more recently performed THE and if other patient factors affected the development of anastomotic leak.
Methods and Procedures
A retrospective chart review of patients who underwent transhiatal esophagectomies at a single institution was performed. Pre-operative comorbidities were noted and a detailed chart review of perioperative course was conducted to identify patient outcomes including atrial fibrillation and anastomotic leak. Univariate analysis was then conducted between patients who developed anastomotic leak after esophagectomy to those who did not.
Results
130 patients who underwent transhiatal esophagectomy were identified between 2012-2020. 12 patients (9.23%) developed a post-operative anastomotic leak. When stratified into groups, those who developed leaks showed no significant difference in gender (p = 0.133) and most comorbidities including hypertension (p = 0.107), diabetes ( p = 0.497), CHF (p = 0.352), and CAD (p = 0.98). Post operative anastomotic leak was significantly correlated with patients who had a history of COPD (p = 0.005). The development of atrial fibrillation was not significantly associated with post operative leak (p = 0.222). Furthermore, the method of survery (minimally invasive versus open) also did not have a significant correlation with the development of a post operative leak (p = 0.462).
Conclusion
Prior studies have established a strong association between post operative atrial fibrillation and anastomotic leak following esophagectomy. Our results suggest that atrial fibrillation is not correlated with development of a leak in the setting of THE. Furthermore, it appears that a preoperative diagnosis of COPD might increase the risk of developing a leak.
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