食管癌切除术后吻合口漏相关生物标志物的系统评价

Biomarkers associated with anastomotic leakage after esophagectomy: a systematic review.

作者信息

Popa Călin, Schlanger Diana, Aiolfi Alberto, ElShafei Moustafa, Triantafyllou Tania, Theodorou Dimitrios, Skrobic Ognjan, Simic Aleksandar, Al Hajjar Nadim, Bonavina Luigi

机构信息

University of Medicine and Pharmacy Iuliu Hatieganu Cluj-Napoca, Regional Institute of Gastroenterology and Hepatology O. Fodor Cluj-Napoca, Croitorilor 19-21, 400162, Cluj-Napoca-Napoca, Romania.

General Surgery, Istituto Clinico Sant'Ambrogio, Milan, Italy.

出版信息

Langenbecks Arch Surg. 2025 Jan 28;410(1):55. doi: 10.1007/s00423-025-03617-8.

DOI:10.1007/s00423-025-03617-8

PMID:39875600

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11775071/

Abstract

PURPOSE

Anastomotic leakage (AL) is one of the most important complications that occurs after upper gastrointestinal surgery, registering rates of 20-30% after esophagectomy. The role of systemic inflammatory biomarkers to predict anastomotic leaks is controversial and needs systematization.

METHODS

A systematic review based on the PRISMA guidelines criteria was performed. PubMed, Scopus, and Embase were queried using MESH Terms and All Fields key words to identify studies investigating a range of immune-inflammatory factors in predicting AL.

RESULTS

Twenty-four studies were included in this review. The total number of included patients was 5903, ranging in each study from 42 to 612. The included studies reported patients that underwent different techniques of esophagectomy (Ivor Lewis, McKeown, Orringer or thoracoabdominal esophagectomy) and 23 out of 24 studies included patients that underwent neoadjuvant treatment. While different biomarkers at different timepoints were analyzed, most studies have indicated postoperative biomarkers, between day 3 and day 5 to reach statistical significance.

CONCLUSIONS

Systemic inflammatory biomarkers represent potential risk stratification and predicting tools for AL after esophageal surgery, but more studies need to be conducted to validate their clinical utility.

摘要

目的

吻合口漏（AL）是上消化道手术后最重要的并发症之一，食管癌切除术后发生率为20%-30%。全身炎症生物标志物在预测吻合口漏方面的作用存在争议，需要进行系统梳理。

方法

基于PRISMA指南标准进行系统评价。使用医学主题词（MESH）和所有字段关键词检索PubMed、Scopus和Embase，以识别研究一系列免疫炎症因子预测AL的研究。

结果

本评价纳入24项研究。纳入患者总数为5903例，每项研究中患者数量从42例到612例不等。纳入研究报告了接受不同食管癌切除技术（艾弗·刘易斯术式、麦克尤恩术式、奥林格术式或胸腹联合食管癌切除术）的患者，24项研究中有23项纳入了接受新辅助治疗的患者。虽然分析了不同时间点的不同生物标志物，但大多数研究表明术后第3天至第5天的生物标志物具有统计学意义。