Table 1. Characteristics of patients undergoing esophagectomy.
| Preoperative Characteristics | Chylothoraxa | No Chylothoraxa | |||
|---|---|---|---|---|---|
|
|
|||||
| n=34 (3.8%) | n=858 (96.2%) | Crude OR (95% CI) | p-value | ||
| Age (median, IQR) | 67.5 (57-75) | 65 (56-73) | 1.04 (0.90, 1.21)b | 0.55 | |
| Male Sex (n, %) | 24 (71%) | 679 (79%) | 0.63 (0.2, 1.35) | 0.23 | |
| BMI | |||||
| BMI < 30 | 29 (88%) | 531 (67%) | 0.013 | ||
| BMI ≥ 30 | 4 (12%) | 257 (33%) | 3.51 (1.22, 10.13) | ||
| Albumin (mg/dl; median, IQR) | 3.7 (3.4, 4.0) | 4 (3.6, 4.2) | 0.94 (0.88, 0.997)c | 0.041 | |
| History of Tobacco Use: (n, %) | 28 (82%) | 620 (75%) | 1.87 (0.64, 3.82) | 0.321 | |
|
| |||||
| Comorbid Conditions | |||||
|
| |||||
| Malignant Disease | 30 (88%) | 792 (92%) | 0.63 (0.21, 1.83) | 0.391 | |
| History of gastroesophageal reflux disease | 17 (52%) | 574 (69%) | 0.49 (0.24, 0.98) | 0.043 | |
| Peptic ulcer disease | 7 (21%) | 73 (9%) | 2.77 (1.16, 6.57) | 0.021 | |
| COPD/Emphysema | 8 (24%) | 109 (13%) | 2.10 (0.93, 4.75) | 0.076 | |
| Previous antireflux surgery | 2 (6.1%) | 60 (7.5%) | 0.80 (0.19, 3.42) | 0.076 | |
| Previous chest surgery | 4 (12%) | 93 (11%) | 1.05 (0.36, 3.04) | 0.931 | |
|
| |||||
| Prior Therapy for Cancer or Barrett’s Esophagus | |||||
|
| |||||
| Induction chemotherapy | 9 (26%) | 244 (28%) | 0.91 (0.42, 1.97) | 0.803 | |
| Induction radiotherapy | 5 (15%) | 141 (16%) | 0.88 (0.33, 2.30) | 0.790 | |
| Endoscopic interventionsf | 10 (33%) | 181 (23%) | 1.69 (0.78, 3.67) | 0.187 | |
|
| |||||
| Operative Details | |||||
|
| |||||
| Approach to Esophagectomy | |||||
| Open | 5 (15%) | 138 (16%) | |||
| Hybridd | 2 (6%) | 54 (6%) | 1.02 (0.19, 5.43) | 0.98 | |
| MIEe | 27 (79%) | 666 (78%) | 1.12 (0.42, 2.96) | 0.42 | |
| Transthoracic esophageal mobilization | 33 (97%) | 747 (87%) | 4.9 (0.66, 36.4) | 0.085 | |
|
| |||||
| Tumor specific variables, if malignant | |||||
|
| |||||
| Proximal or middle esophagus tumor location | 5 (17%) | 57 (8%) | 2.47 (0.91, 6.72) | 0.078 | |
| Squamous tumor type | 9 (30%) | 90 (11%) | 3.3 (1.48, 7.56) | 0.002 | |
| Adenocarcinoma tumor type | 17 (57%) | 592 (75%) | 0.44 (0.21, 0.93) | 0.030 | |
| Tumor invasion at esophagectomy (T3 or T4) | 17 (59%) | 352 (45%) | 1.70 (0.80, 3.60) | 0.168 | |
| Number of lymph nodes examined (median, IQR) | 17 (12.5, 25) | 18 (12, 26) | 1.02 (0.99, 1.05) | 0.310 | |
| Nodal metastasis at esophagectomy | 16 (53%) | 343 (46%) | 1.27 (0.62, 2.57) | 0.511 | |
Not all criteria were in the record and able to be abstracted for every patient; therefore, the reported % are based on total patients for whom the criteria was recorded
For each increase of 5 years
For each increase of serum albumin of 0.1 mg/dl
Hybrid approach includes planned thoracotomy with laparoscopy or thoracoscopy with laparotomy
MIE consists of thoracoscopic mobilization of esophagus followed by laparoscopic creation of gastric conduit and mediastinal pull-through of the neoesophagus with cervical anastomosis or intrathoracic anastomosis at or above the level of the divided azygous vein
Preoperative endoscopic interventions included photodynamic therapy, esophageal stenting and dilation
CI, confidence interval; BMI, body mass index; COPD, chronic obstructive pulmonary disease; IQR, interquartile range; MIE, minimally invasive esophagectomy.