Chen Lai-Te, Jiang Chen-Yang
Zhejiang University Sir Run Run Shaw Hospital, Zhejiang University, School of Medicine, Hangzhou, China.
Medicine (Baltimore). 2018 Jun;97(23):e10948. doi: 10.1097/MD.0000000000010948.
Postoperative atrial arrhythmias (PAAs) are common complications after esophagectomy, however research findings are contradicted on the prognosis. Therefore this meta-analysis was conducted to determine whether PAAs after esophagectomy had an impact on prognosis.
Studies comparing prognosis between patients with and without PAAs after esophagectomy were searched in EMBASE, MEDLINE, and the Cochrane Register. Primary prognosis was perioperative mortality, and secondary prognoses were postoperative complications, length of stay (LOS).
Ten studies including 2681 patients were included in this analysis, in which 508 patients (18.9%) experienced PAAs. Patients with PAAs resulted in significantly higher perioperative (odds ratio, OR 4.05[95% confidence interval, CI: 2.45-6.70], P = .40) mortality, longer hospital LOS (mean differences, MD: 1.49 [95% CI: 0.32-2.66]days, P = .01), more incidence of pulmonary pneumonia (OR 2.48 [95% CI: 1.71-3.59], P < .00001), and anastomotic leakage (OR 2.37 [95% CI: 1.39-4.03], P < .00001).
Atrial arrhythmias (AAs) after esophagectomy are associated with higher perioperative mortality, longer hospital LOS, and more incidences of complications. Therapeutic strategies against PAAs are pending for further researches.
术后房性心律失常（PAAs）是食管切除术后常见的并发症，然而关于其预后的研究结果存在矛盾。因此，进行了这项荟萃分析以确定食管切除术后的PAAs是否对预后有影响。
在EMBASE、MEDLINE和Cochrane注册库中检索比较食管切除术后有和无PAAs患者预后的研究。主要预后指标是围手术期死亡率，次要预后指标是术后并发症、住院时间（LOS）。
本分析纳入了10项研究，共2681例患者，其中508例（18.9%）发生PAAs。发生PAAs的患者围手术期死亡率显著更高（比值比，OR 4.05[95%置信区间，CI：2.45 - 6.70]，P = 0.40），住院时间更长（平均差，MD：1.49[95% CI：0.32 - 2.66]天，P = 0.01），肺炎发生率更高（OR 2.48[95% CI：1.71 - 3.59]，P < 0.00001），吻合口漏发生率更高（OR 2.37[95% CI：1.39 - 4.03]，P < 0.00001）。
食管切除术后房性心律失常（AAs）与更高的围手术期死亡率、更长的住院时间和更多的并发症发生率相关。针对PAAs的治疗策略有待进一步研究。
