Impact of Arterial Partial Pressure of Oxygen on Anastomotic Leakage After Esophagectomy

Sun Yat-sen University

Status: Completed

Conditions: PaO2; Esophageal Carcinoma; Esophagectomy; Esophageal Adenocarcinoma; Esophageal Anastomotic Leakeage

Study type: Observational

Funder types: Other

Identifiers

NCT07309991

B2025-825-01

Details and patient eligibility

About

This study aims to determine whether postoperative hypoxia (arterial partial pressure of oxygen (PaO₂)<80 mmHg) is an independent risk factor for anastomotic leakage after esophagectomy. We conducted a retrospective analysis of cases from our center over the past five years, stratifying patients into Low Pa0₂ Group and Normal Pa0₂ Group based on postoperative oxygen levels and comparing the incidence of anastomotic leakage between the groups. The goal is to establish whether hypoxia is a causative risk factor and whether correcting it can reduce the risk of anastomotic leakage.

Full description

This retrospective study included all patients who underwent radical esophagectomy at our center over the past five years. After screening based on inclusion and exclusion criteria, PaO₂ levels within the first postoperative week were recorded (the lowest value was used if multiple measurements were taken on the same day), along with whether the condition improved after corrective interventions, patients were accordingly divided into Low Pa0₂ Group (at least one recorded instance of PaO₂ <80 mmHg) and Normal Pa0₂ Group. Anastomotic leakage was diagnosed based on barium swallow, endoscopy, chest-abdominal CT, or typical clinical signs. By comparing the incidence of anastomotic leakage between the two groups, the relationship between postoperative PaO₂ and anastomotic leakage was analyzed, with further investigation into whether postoperative hypoxemia constitutes an independent and modifiable risk factor.

Enrollment: 2,083 patients

Sex: All

Ages: 18 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• The inclusion criteria required patients diagnosed with esophageal carcinoma or benign esophageal tumors and requiring surgical resection of the lesion with subsequent esophageal reconstruction. Additionally, patients must have had at least one postoperative arterial blood gas analysis and routinely undergone either endoscopy, CT scan, or esophagram for postoperative evaluation of the anastomosis.

Exclusion criteria

• We excluded patients who did not require esophageal reconstruction, those undergoing esophageal replacement with colon, and those with incomplete data.

Trial design

2,083 participants in 2 patient groups

Low Pa02 Group

Description:

Patients were defined as belonging to the Low PaO₂ group if they exhibited at least one recorded instance of PaO₂ \<80 mmHg within the first postoperative week.

Normal PaO2 Group

Description:

Patients maintained a PaO₂ ≥80 mmHg throughout the first postoperative week.