TY - JOUR
T1 - Surgical Outcomes After Esophagectomy in Patients with Achalasia
T2 - a NSQIP Matched Analysis With Non-Achalasia Esophagectomy Patients
AU - Torres-Landa, Samuel
AU - Crafts, Trevor D.
AU - Jones, Amy E.
AU - Dewey, Elizabeth N.
AU - Wood, Stephanie G.
N1 - Publisher Copyright:
© 2021, The Society for Surgery of the Alimentary Tract.
PY - 2021/10
Y1 - 2021/10
N2 - Purpose: The data on surgical outcomes of esophagectomy in patients with achalasia is limited. We sought to evaluate surgical outcomes in achalasia patients after an esophagectomy versus non-achalasia patients to elucidate if the outcomes are affected by the diagnosis. Methods: We conducted a retrospective review of the National Surgical Quality Improvement Program database (2010–2018). Patients who underwent an esophagectomy (open or laparoscopic approach) were included. Patients were divided into two groups, achalasia vs non-achalasia patients, and matched using propensity match analysis. Results: Of the 10,997 esophagectomy patients who met inclusion criteria, 213 (1.9%) patients had a diagnosis of achalasia. A total of 418 patients were included for the final analysis, with 209 patients in each group (achalasia vs non-achalasia). The overall median age was 57 years (IQR 47–65 years), and 48.6% were female. Most underwent an open (93.1%) vs laparoscopic (6.9%) esophagectomy. Overall complication rate was 40%. No difference was identified on overall complications, readmission, reoperation, or mortality between both groups. Postoperative sepsis was significantly higher in the achalasia group, and organ space SSI was higher in the non-achalasia group. Multivariable analysis showed that a diagnosis (achalasia or non-achalasia) was not predictive of reoperation or overall complications. Conclusion: Esophagectomy outcomes are similar in patients with achalasia vs non-achalasia, and the diagnosis of achalasia does not independently increase the risk of reoperation and overall complications. Finally, regardless of diagnosis, the potential for morbidity following esophagectomy, should to be discussed with patients in the preoperative setting.
AB - Purpose: The data on surgical outcomes of esophagectomy in patients with achalasia is limited. We sought to evaluate surgical outcomes in achalasia patients after an esophagectomy versus non-achalasia patients to elucidate if the outcomes are affected by the diagnosis. Methods: We conducted a retrospective review of the National Surgical Quality Improvement Program database (2010–2018). Patients who underwent an esophagectomy (open or laparoscopic approach) were included. Patients were divided into two groups, achalasia vs non-achalasia patients, and matched using propensity match analysis. Results: Of the 10,997 esophagectomy patients who met inclusion criteria, 213 (1.9%) patients had a diagnosis of achalasia. A total of 418 patients were included for the final analysis, with 209 patients in each group (achalasia vs non-achalasia). The overall median age was 57 years (IQR 47–65 years), and 48.6% were female. Most underwent an open (93.1%) vs laparoscopic (6.9%) esophagectomy. Overall complication rate was 40%. No difference was identified on overall complications, readmission, reoperation, or mortality between both groups. Postoperative sepsis was significantly higher in the achalasia group, and organ space SSI was higher in the non-achalasia group. Multivariable analysis showed that a diagnosis (achalasia or non-achalasia) was not predictive of reoperation or overall complications. Conclusion: Esophagectomy outcomes are similar in patients with achalasia vs non-achalasia, and the diagnosis of achalasia does not independently increase the risk of reoperation and overall complications. Finally, regardless of diagnosis, the potential for morbidity following esophagectomy, should to be discussed with patients in the preoperative setting.
KW - Achalasia
KW - NSQIP
KW - end-stage
KW - esophagectomy
KW - short-term
UR - http://www.scopus.com/inward/record.url?scp=85108012966&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85108012966&partnerID=8YFLogxK
U2 - 10.1007/s11605-021-05056-4
DO - 10.1007/s11605-021-05056-4
M3 - Article
C2 - 34131865
AN - SCOPUS:85108012966
SN - 1091-255X
VL - 25
SP - 2455
EP - 2462
JO - Journal of Gastrointestinal Surgery
JF - Journal of Gastrointestinal Surgery
IS - 10
ER -