Impact of Minimally Invasive Esophagectomy in Post-Operative Atrial Fibrillation and Long-Term Mortality in Patients Among Esophageal Cancer

Abstract

Aims: Postoperative Atrial fibrillation (POAF) after esophagectomy may prolong stay in intensive care and increase risk of perioperative complications. A minimally invasive approach is becoming the preferred option for esophagectomy, yet its implications for POAF risk remains unclear. The association between POAF and minimally invasive esophagectomy (MIE) was examined in this study. Methods: We used a dataset of 575 patients who underwent esophagectomy. Multivariate logistic regression analysis was performed to examine the association between MIE and POAF. A cox proportional hazards model was applied to assess the long-term mortality (MIE vs open esophagectomy, OE). Results: Of the 575 patients with esophageal cancer, 62 developed POAF. MIE was negatively associated with the occurrence of POAF (Odds ratio: 0.163, 95%CI: 0.033-0.801). No significant difference was observed in long-term mortality (Odds ratio: 2.144, 95%CI: 0.963-4.775). Conclusions: MIE may reduced the incidence of POAF without compromising the survival of patients with esophageal cancer. Moreover, the specific mechanism of MIE providing this possible advantage needs to be determined by larger prospective cohort studies with specific biomarker information from laboratory tests.

Risk factors for the development of postoperative atrial fibrillation after esophagectomy for esophageal cancer

“…They did not find an increased rate of POAF in the minimally invasive esophagectomy group compared with prior reported rates in open esophagectomy populations. On the contrary, Chen et al [ 11 ] reported that MIE was negatively associated with the onset of POAF in a dataset of 575 patients. Different size of study population and analysis methods may be the potential reasons for these inconsistent findings.…”

“…Several studies have investigated the risk factors of POAF following esophagectomy. [ 6 , 7 , 11 , 12 ] However, the results were inconsistent because of the different size of study population and analysis methods. A meta-analysis was conducted to investigate the risk factors and subsequent events associated with the onset of POAF following esophagectomy.…”