A. Imdahl et al., PERIOPERATIVE RISK-FACTORS IN PATIENTS WITH ESOPHAGEAL-CARCINOMA - A RETROSPECTIVE STUDY TO IDENTIFY INDEPENDENT VARIABLES, Zentralblatt fur Chirurgie, 118(4), 1993, pp. 190-196
The postoperative outcome of 127 patients with an esophageal carcinoma
was investigated retrospectively, to identify independent factors for
the perioperative mortality (hospital mortality). Chi-square single f
actor analysis was employed to test 35 independent variables, in a sec
ond analysis stepwise logistic regression was used to determine the fa
ctors correlating with the mortality. In 41 patients the esophagus was
resected by a thoraco-abdominal approach, in 86 by blunt dissection.
The hospital mortality was 17.3 %, the 30-day mortality 12.6 %. Single
factor analysis revealed a significant correlation with the variable
smoking (p < 0.003), post-operative morbidity (p < 0.008), CEA (p < 0.
02), time of operation (p < 0.02) and surgical procedures (p < 0.02).
The influence of die surgeon's experience was significant. In the step
wise logistic regression the duration of operation (p < 0.0039), the s
urgical procedures (p < 0.0 1 6), and the units of blood (p < 0.03) we
re correlated with mortality. The logistic regression showed a signifi
cant increase of mortality for the thoracoabdominal approach with incr
easing duration of the operation. The estimation of survival time acco
rding to Kaplan and Meier revealed a significant correlation with the
stage of the tumor, but not with the surgical procedure.