Use of vasopressors during esophagectomy is not associated with increased risk of anastomotic leak Journal Article


Authors: Walsh, K. J.; Zhang, H.; Tan, K. S.; Pedoto, A.; Desiderio, D. P.; Fischer, G. W.; Bains, M. S.; Jones, D. R.; Molena, D.; Amar, D.
Article Title: Use of vasopressors during esophagectomy is not associated with increased risk of anastomotic leak
Abstract: Vasopressor use during esophagectomy has been reported to increase the risk of postoperative anastomotic leak and associated morbidity. We sought to assess the association between vasopressor use and fluid (crystalloid and colloid) administration and anastomotic leak following open esophagectomy. Patients who underwent open Ivor Lewis esophagectomy were identified from a prospective institutional database. The primary outcome was postoperative anastomotic leak (any grade) and analyzed using logistic regression models. Postoperative anastomotic leak developed in 52 of 327 consecutive patients (16%) and was not significantly associated with vasopressor use or fluid administered in either univariable or multivariable analyses. Increasing body mass index was the only significant characteristic of both univariable (P = 0.004) and multivariable analyses associated with anastomotic leak (odds ratio, 1.05; 95% confidence interval, 1.01-1.09; P = 0.007). Of the 52 patients that developed an anastomotic leak, 12 (23%) were grade 1, 21 (40%) were grade 2 and 19 (37%) were grade 3. In our cohort, only body mass index, and not intraoperative vasopressor use and fluid administration, was significantly associated with increased odds of postoperative anastomotic leak following open Ivor Lewis esophagectomy. © The Author(s) 2020. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Keywords: complications; phenylephrine; thoracic surgery; esophagogastrectomy; norepinephrine
Journal Title: Diseases of the Esophagus
Volume: 34
Issue: 4
ISSN: 1120-8694
Publisher: Oxford University Press  
Date Published: 2021-04-01
Start Page: doaa090
Language: English
DOI: 10.1093/dote/doaa090
PUBMED: 32944749
PROVIDER: scopus
PMCID: PMC8024447
DOI/URL:
Notes: Article -- Export Date: 3 May 2021 -- Source: Scopus
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. Alessia C Pedoto
    40 Pedoto
  2. David Amar
    137 Amar
  3. Manjit S Bains
    338 Bains
  4. Hao Zhang
    62 Zhang
  5. David Randolph Jones
    417 Jones
  6. Daniela   Molena
    271 Molena
  7. Kay See   Tan
    241 Tan
  8. Kevin James Walsh
    4 Walsh
  9. Gregory Walter Fischer
    40 Fischer