Transthoracic approach is associated with increased incidence of atrial fibrillation after esophageal resection

Kush R. Lohani, Kalyana C. Nandipati, Sarah E. Rollins, Katharina Fetten, Tommy H. Lee, Pradeep K. Pallati, Se Ryung Yamamoto, Sumeet K. Mittal

Research output: Contribution to journalArticle

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Abstract

Aim: Atrial fibrillation (AF) has been associated with higher morbidity after esophagectomy. The objective of this study is to identify the surgical risk factors associated with new-onset atrial fibrillation after esophagectomy. Methods: After Institutional Review Board approval, a prospectively maintained database was retrospectively queried to identify patients who underwent esophagectomy between 2003 and 2013. Data variables collected include pre-operative, intra-operative, and post-operative factors. Appropriate statistical analysis is performed utilizing Sigmaplot® version 12.3. Results: From 2003 to 2013, 245 esophagectomies were performed at our institution, of these, 192 (147 males, mean age of 62 ± 11.12 years) were included in the final analysis and 53 were excluded [25 Roux-en-Y reconstruction (including three Merendino procedures), 20 had AF before surgery, and eight with staged esophagectomy]. Of 192 esophagectomies, 160 had malignancy (138 adenocarcinoma and 22 squamous cell carcinoma) and 106 (66.25 %) received neo-adjuvant therapy. Esophagectomies were performed with Ivor Lewis Mckeown approach in 78 patients [34 Minimally Invasive (MIE), 37 open, and 7 Hybrid], Ivor Lewis approach in 56 patients (31 MIE, 10 Open, 15 Hybrid) and Transhiatal approach in 58 patients (16 MIE and 42 Open). Gastric conduit was used in 185 patients and colonic conduit in seven patients. Overall 30-day or in-hospital mortality was 3.6 % (7/192). Forty-five (23.4 %) patients with esophagectomy developed new-onset AF. Median onset of AF was post-op day 3 (0–32). They were older (65.7 vs. 61.3, p = 0.021), with medical comorbidities (thyroid disorder, hyperlipidemia, and coronary artery disease; p 

Original languageEnglish
Pages (from-to)2039-2045
Number of pages7
JournalSurgical Endoscopy
Volume29
Issue number7
DOIs
StatePublished - Jul 19 2015

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Esophagectomy
Atrial Fibrillation
Incidence
Research Ethics Committees
Hospital Mortality
Hyperlipidemias
Comorbidity
Coronary Artery Disease
Squamous Cell Carcinoma
Stomach
Thyroid Gland
Adenocarcinoma
Databases
Morbidity

All Science Journal Classification (ASJC) codes

  • Surgery

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Transthoracic approach is associated with increased incidence of atrial fibrillation after esophageal resection. / Lohani, Kush R.; Nandipati, Kalyana C.; Rollins, Sarah E.; Fetten, Katharina; Lee, Tommy H.; Pallati, Pradeep K.; Yamamoto, Se Ryung; Mittal, Sumeet K.

In: Surgical Endoscopy, Vol. 29, No. 7, 19.07.2015, p. 2039-2045.

Research output: Contribution to journalArticle

Lohani, KR, Nandipati, KC, Rollins, SE, Fetten, K, Lee, TH, Pallati, PK, Yamamoto, SR & Mittal, SK 2015, 'Transthoracic approach is associated with increased incidence of atrial fibrillation after esophageal resection', Surgical Endoscopy, vol. 29, no. 7, pp. 2039-2045. https://doi.org/10.1007/s00464-014-3908-9
Lohani, Kush R. ; Nandipati, Kalyana C. ; Rollins, Sarah E. ; Fetten, Katharina ; Lee, Tommy H. ; Pallati, Pradeep K. ; Yamamoto, Se Ryung ; Mittal, Sumeet K. / Transthoracic approach is associated with increased incidence of atrial fibrillation after esophageal resection. In: Surgical Endoscopy. 2015 ; Vol. 29, No. 7. pp. 2039-2045.
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abstract = "Aim: Atrial fibrillation (AF) has been associated with higher morbidity after esophagectomy. The objective of this study is to identify the surgical risk factors associated with new-onset atrial fibrillation after esophagectomy. Methods: After Institutional Review Board approval, a prospectively maintained database was retrospectively queried to identify patients who underwent esophagectomy between 2003 and 2013. Data variables collected include pre-operative, intra-operative, and post-operative factors. Appropriate statistical analysis is performed utilizing Sigmaplot{\circledR} version 12.3. Results: From 2003 to 2013, 245 esophagectomies were performed at our institution, of these, 192 (147 males, mean age of 62 ± 11.12 years) were included in the final analysis and 53 were excluded [25 Roux-en-Y reconstruction (including three Merendino procedures), 20 had AF before surgery, and eight with staged esophagectomy]. Of 192 esophagectomies, 160 had malignancy (138 adenocarcinoma and 22 squamous cell carcinoma) and 106 (66.25 {\%}) received neo-adjuvant therapy. Esophagectomies were performed with Ivor Lewis Mckeown approach in 78 patients [34 Minimally Invasive (MIE), 37 open, and 7 Hybrid], Ivor Lewis approach in 56 patients (31 MIE, 10 Open, 15 Hybrid) and Transhiatal approach in 58 patients (16 MIE and 42 Open). Gastric conduit was used in 185 patients and colonic conduit in seven patients. Overall 30-day or in-hospital mortality was 3.6 {\%} (7/192). Forty-five (23.4 {\%}) patients with esophagectomy developed new-onset AF. Median onset of AF was post-op day 3 (0–32). They were older (65.7 vs. 61.3, p = 0.021), with medical comorbidities (thyroid disorder, hyperlipidemia, and coronary artery disease; p ",
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AU - Lohani, Kush R.

AU - Nandipati, Kalyana C.

AU - Rollins, Sarah E.

AU - Fetten, Katharina

AU - Lee, Tommy H.

AU - Pallati, Pradeep K.

AU - Yamamoto, Se Ryung

AU - Mittal, Sumeet K.

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AB - Aim: Atrial fibrillation (AF) has been associated with higher morbidity after esophagectomy. The objective of this study is to identify the surgical risk factors associated with new-onset atrial fibrillation after esophagectomy. Methods: After Institutional Review Board approval, a prospectively maintained database was retrospectively queried to identify patients who underwent esophagectomy between 2003 and 2013. Data variables collected include pre-operative, intra-operative, and post-operative factors. Appropriate statistical analysis is performed utilizing Sigmaplot® version 12.3. Results: From 2003 to 2013, 245 esophagectomies were performed at our institution, of these, 192 (147 males, mean age of 62 ± 11.12 years) were included in the final analysis and 53 were excluded [25 Roux-en-Y reconstruction (including three Merendino procedures), 20 had AF before surgery, and eight with staged esophagectomy]. Of 192 esophagectomies, 160 had malignancy (138 adenocarcinoma and 22 squamous cell carcinoma) and 106 (66.25 %) received neo-adjuvant therapy. Esophagectomies were performed with Ivor Lewis Mckeown approach in 78 patients [34 Minimally Invasive (MIE), 37 open, and 7 Hybrid], Ivor Lewis approach in 56 patients (31 MIE, 10 Open, 15 Hybrid) and Transhiatal approach in 58 patients (16 MIE and 42 Open). Gastric conduit was used in 185 patients and colonic conduit in seven patients. Overall 30-day or in-hospital mortality was 3.6 % (7/192). Forty-five (23.4 %) patients with esophagectomy developed new-onset AF. Median onset of AF was post-op day 3 (0–32). They were older (65.7 vs. 61.3, p = 0.021), with medical comorbidities (thyroid disorder, hyperlipidemia, and coronary artery disease; p 

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