Prediction and stratification for the surgical adverse events after minimally invasive esophagectomy:A two-center retrospective study  

作　　者：Qi-Hong Zhong Jiang-Shan Huang Fei-Long Guo Jing-Yu Wu Mao-Xiu Yuan Jia-Fu Zhu Wen-Wei Lin Sui Chen Zhen-Yang Zhang Jiang-Bo Lin 

机构地区：[1]Department of Thoracic Surgery,Fujian Medical University Union Hospital,Fuzhou 350001,Fujian Province,China [2]The Graduate School,Fujian Medical University,Fuzhou 350001,Fujian Province,China [3]Department of Thoracic Surgery,Affiliated Hospital of Jinggangshan University,Ji’an 343000,Jiangxi Province,China

出　　处：《World Journal of Gastroenterology》2025年第3期50-61,共12页世界胃肠病学杂志（英文）

基　　金：Supported by Joint Funds for the Innovation of Science and Technology,Fujian Province,No.2023Y9187 and No.2021Y9057.

摘　　要：BACKGROUND Minimally invasive esophagectomy(MIE)is a widely accepted treatment for esophageal cancer,yet it is associated with a significant risk of surgical adverse events(SAEs),which can compromise patient recovery and long-term survival.Accurate preoperative identification of high-risk patients is critical for improving outcomes.AIM To establish and validate a risk prediction and stratification model for the risk of SAEs in patients with MIE.METHODS This retrospective study included 747 patients who underwent MIE at two centers from January 2019 to February 2024.Patients were separated into a train set(n=549)and a validation set(n=198).After screening by least absolute shrinkage and selection operator regression,multivariate logistic regression analyzed clinical and intraoperative variables to identify independent risk factors for SAEs.A risk stratification model was constructed and validated to predict the probability of SAEs.RESULTS SAEs occurred in 10.2%of patients in train set and 13.6%in the validation set.Patients with SAE had significantly higher complication rate and a longer hospital stay after surgery.The key independent risk factors identified included chronic obstructive pulmonary disease,a history of alcohol consumption,low forced expiratory volume in the first second,and low albumin levels.The stratification model has excellent prediction accuracy,with an area under the curve of 0.889 for the training set and an area under the curve of 0.793 for the validation set.CONCLUSION The developed risk stratification model effectively predicts the risk of SAEs in patients undergoing MIE,facilitating targeted preoperative interventions and improving perioperative management.

关 键 词：Surgical adverse events Minimally invasive esophagectomy Esophageal cancer Stratification model Perioperative management 

分 类 号：R735.1[医药卫生—肿瘤]