Analysis of the relationship between deep venous catheter-related infection and post-operative complications in patients receiving minimally invasive esophagectomy

Abstract

Abstract Objective The aim of the study was to evaluate catheter-related infection rate (CRIR) for patients receiving minimally invasive esophagectomy (MIE), to identify the optimal catheterization approach and relationship between CRIR and post-operative complications. Methods In total, 168 patients with esophageal carcinoma and undergoing MIE combined with pre-operative deep venous catheterization (DVC) were analyzed in our institution (Qingdao Municipal Hospital, China), from 2014 to 2018. After completing DVC, catheter-tips together with intraductal venous blood samples were sent to the microbiology lab for bacterial strain culture. CRIR was statistically evaluated for the following clinical variables: gender, age, smoking status, drinking status, past history, tumor location, histologic grade, pathological T, N, and M category, anastomotic location, anastomotic leakage, anastomotic stricture, chylothorax, pneumonia, recurrent laryngeal nerve (RLN) injury, reflux esophagitis, catheterization site, and catheter-locking days. Results Among the 144 patients recruited in our study, 105 catheters were inserted into the jugular vein and 39 catheters into the subclavian vein. The median age of these patients was 63 years (range: 42-79 years), and the median catheter-locking period was seven days (range: 4-21 days). Four catheters were identified with three types of strain colonizations, including Staphylococcus epidermidis, Staphylococcus aureus and Blastomyces albicans. Statistical data showed that patients diagnosed with catheter-related infection were likely to incur anastomotic leakage (66.67%, P < 0.001) and pneumonia (27.27%, P < 0.001); features such as tumors located in the upper esophagus (13.6%, P = 0.003), and over seven catheter-locking days (10.00%, P < 0.001) were attributed to a high CRIR. Conclusion Although both jugular and subclavian veins can be catheterized for patients with MIE, DVC is associated with more than seven catheter-locking days and upper esophagectomy, due to high CRIR. Furthermore, catheter-related infection is related to anastomotic leakage and pneumonia.