Reoperative Surgery After Minimally Invasive Ivor Lewis Esophagectomy

Abstract

Objective: The aim of this study is to identify factors influencing reoperations following minimally invasive Ivor Lewis esophagectomy and associated mortality and hospital costs.Materials and Methods: Between 2013 and 2018, 125 patients were retrospectively analyzed. Outcomes included reoperations, mortality, and hospital costs. Multivariable logistic regression analyses determined factors associated with reoperations.Results: In-hospital reoperations (n = 10) were associated with inhospital mortality (n = 3, P < 0.01), higher hospital costs (P < 0.01), and longer hospital stay (P < 0.01). Conversely, reoperations after discharge were not associated with mortality. By multivariable analysis, baseline cardiovascular (P = 0.02) and chronic kidney disease (P = 0.01) were associated with reoperations. However, anastomotic leaks were not associated with reoperations nor mortality. Conclusion:The majority of reoperations occur within 30 days often during index hospitalization. Reoperations were associated with increased in-hospital mortality and hospital costs. Notably, anastomotic leaks did not influence reoperations nor mortality. Efforts to optimize patient baseline comorbidities should be emphasized to minimize reoperations following minimally invasive Ivor Lewis esophagectomy.