ArticleJournal of thoracic disease2025
Association of perioperative cholesterol depletion with anastomotic leak after esophagectomy for cancer: a retrospective study.
Article in Journal of thoracic disease, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Anastomotic leak (AL) remains one of the most severe complications following esophagectomy. Malnutrition is a risk factor for postoperative complications, and many nutritional indicators are also associated with postoperative stress and inflammatory responses. This study aimed to evaluate the relationship between AL and three nutritional risk indices: the Prognostic Nutritional Index (PNI), Geriatric Nutritional Risk Index (GNRI), and Controlling Nutritional Status (CONUT) score. Methods: We retrospectively analyzed 1,749 patients who underwent esophagectomy from August 2018 to January 2023. Preoperative and postoperative day 1 (POD1) PNI, GNRI, and CONUT scores were calculated, along with their perioperative changes. The association between these indices and AL development was assessed. Univariate and multivariate analyses were performed to screen for prognostic factors. Results: Among 1,749 patients, 145 (8.3%) developed AL. No significant differences were observed in PNI changes (-13.6±6.2 Conclusions: The cholesterol depletion was significantly associated with AL occurrence and can serve as an independent risk factor. This association suggests that acute cholesterol depletion may be a biomarker of a more profound systemic stress response, which in turn, critically impairs anastomotic healing.
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