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食管切除术后心房颤动相关危险因素及并发症的荟萃分析。

Meta-analysis of risk factors and complications associated with atrial fibrillation after oesophagectomy.

机构信息

First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece.

251 VA and Hellenic Air Force Hospital, Athens, Greece.

出版信息

Br J Surg. 2019 Apr;106(5):534-547. doi: 10.1002/bjs.11128.


DOI:10.1002/bjs.11128
PMID:30908612
Abstract

BACKGROUND: Oesophagectomy is associated with high morbidity and mortality rates. New-onset atrial fibrillation (AF) is a frequent complication following oesophagectomy. Several studies have explored whether new-onset AF is associated with adverse events after oesophagectomy. METHODS: This review was performed according to PRISMA guidelines. Eligible studies were identified through a search of PubMed, Scopus and Cochrane CENTRAL databases up to 25 November 2018. A meta-analysis was conducted with the use of random-effects modelling. The I statistic was used to assess for heterogeneity. RESULTS: In total, 53 studies including 9087 patients were eligible for analysis. The overall incidence of postoperative AF was 16·5 per cent. Coronary artery disease and hypertension were associated with AF, whereas diabetes, smoking and chronic obstructive pulmonary disease were not. Patients with AF had a significantly higher risk of overall postoperative adverse events than those without fibrillation (odds ratio (OR) 5·50, 95 per cent c.i. 3·51 to 8·30), including 30-day mortality (OR 2·49, 1·70 to 3·64), anastomotic leak (OR 2·65, 1·53 to 4·59) and pneumonia (OR 3·42, 2·39 to 4·90). CONCLUSION: Postoperative AF is frequently observed in patients undergoing oesophagectomy for cancer. It is associated with an increased risk of death and postoperative complications.

摘要

背景:食管癌切除术的发病率和死亡率都很高。新发心房颤动(AF)是食管癌切除术后的常见并发症。几项研究探讨了新发 AF 是否与食管癌切除术后的不良事件有关。

方法:本综述按照 PRISMA 指南进行。通过对 PubMed、Scopus 和 Cochrane CENTRAL 数据库进行检索,截至 2018 年 11 月 25 日,确定了符合条件的研究。使用随机效应模型进行荟萃分析。使用 I 统计量评估异质性。

结果:共有 53 项研究,包括 9087 例患者,符合分析条件。术后 AF 的总体发生率为 16.5%。冠心病和高血压与 AF 相关,而糖尿病、吸烟和慢性阻塞性肺疾病则没有。AF 患者的总体术后不良事件风险显著高于无房颤患者(比值比 5.50,95%置信区间 3.51 至 8.30),包括 30 天死亡率(比值比 2.49,1.70 至 3.64)、吻合口漏(比值比 2.65,1.53 至 4.59)和肺炎(比值比 3.42,2.39 至 4.90)。

结论:癌症患者行食管癌切除术常发生术后 AF。它与死亡和术后并发症的风险增加有关。

相似文献

[1]
Meta-analysis of risk factors and complications associated with atrial fibrillation after oesophagectomy.

Br J Surg. 2019-4

[2]
The predictive value of new-onset atrial fibrillation on postoperative morbidity after esophagectomy.

Dis Esophagus. 2018-11-1

[3]
Impact of atrial fibrillation on long-term survival following oesophagectomy: a 21-year observational study.

ANZ J Surg. 2018-4

[4]
Incidence and impact of postoperative atrial fibrillation after minimally invasive esophagectomy.

Dis Esophagus. 2016-8

[5]
Atrial fibrillation after esophagectomy: an indicator of postoperative morbidity.

Gen Thorac Cardiovasc Surg. 2011-6

[6]
Age and neo-adjuvant chemotherapy increase the risk of atrial fibrillation following oesophagectomy.

Eur J Cardiothorac Surg. 2012-3-4

[7]
Association between Postoperatively Developed Atrial Fibrillation and Long-Term Mortality after Esophagectomy in Esophageal Cancer Patients: An Observational Study.

PLoS One. 2016-5-5

[8]
Transthoracic approach is associated with increased incidence of atrial fibrillation after esophageal resection.

Surg Endosc. 2015-7

[9]
Elderly patients have increased perioperative morbidity and mortality from oesophagectomy for oesophageal cancer: A systematic review and meta-analysis.

Eur J Surg Oncol. 2021-8

[10]
Randomized clinical trial of landiolol hydrochloride for the prevention of atrial fibrillation and postoperative complications after oesophagectomy for cancer.

Br J Surg. 2017-4-26

引用本文的文献

[1]
The impact of postoperative atrial fibrillation on complications and mortality following Ivor Lewis esophagectomy for esophageal cancer.

Sci Rep. 2025-7-1

[2]
Causal associations between atrial fibrillation and esophageal cancer: a two-sample Mendelian randomization study.

Transl Cancer Res. 2025-3-30

[3]
Influence of dental status on postoperative complications in major visceral surgical and organ transplantation procedures-the bellydent retrospective observational study.

Langenbecks Arch Surg. 2024-9-19

[4]
Landiolol for Treatment of New-Onset Atrial Fibrillation in Critical Care: A Systematic Review.

J Clin Med. 2024-5-17

[5]
Long-term survival outcomes of esophagectomy with off-pump CABG versus esophagectomy alone.

Surg Endosc. 2024-7

[6]
Coexisting atrial fibrillation and cancer: time trends and associations with mortality in a nationwide Dutch study.

Eur Heart J. 2024-7-9

[7]
Short- and Long-Term Outcomes of Patients with Postoperative Arrhythmia after Liver Surgery.

Biomedicines. 2024-1-25

[8]
2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.

J Am Coll Cardiol. 2024-1-2

[9]
2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.

Circulation. 2024-1-2

[10]
Development of a Survival Nomogram for Esophageal Squamous Cell Carcinoma Patients: a Population-Based Analysis.

J Gastrointest Cancer. 2024-3

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