Influence of high body mass index on early complications after radical surgery for esophageal carcinoma

Abstract

Objective To investigate the influence of high body mass index(BMI) on early complications after radical surgery for esophageal carcinoma. Methods The clinical data of 228 patients with thoracic segment esophageal carcinoma undergoing resection with thoracoscope and laparoscope plus thoraco-abdominal 2-field lymphadenectomy plus replacement of esophagus by stomach(through esophagus bed) plus percutaneous endoscopic jejunostomy between January 2014 and December 2015 in Department of Cardiothoracic Surgery, Fujian Medical University Union Hospital were retrospectively analyzed. Patients with preoperative adjuvant radio-chemotherapy treatment, hypoalbuminema(≤35 g/L), basic cardiopulmonary diseases and low BMI(BMI<18.5 kg/m2) were excluded. The clinical data of 151 eligible patients were ultimately collected, and patients were divided into normal BMI group(18.5 kg/m2≤BMI<24 kg/m2,n=92) and high BMI group(BMI≥24 kg/m2,n=59). The prevalences of postoperative complications were compared. Results The prevalences of postoperative anastomotic leakage and pulmonary complications in high BMI group were significantly higher than those in normal BMI group(23.7% vs 7.6%, χ2=7.80, P<0.01; 84.7% vs 68.5%, χ2=5.05, P<0.05). There was no significant difference in the incidence rates of incision infection, cardiac complications and chylothorax between two groups(χ2=0.12, χ2=0.48, χ2=0.23, P<0.05 for all). Conclusions Compared with patients with normal BMI, those with high BMI are prone to anastomotic leakage and pulmonary complications. The clinical treatment of early complications after radical surgery for esophageal carcinoma can be guided on the basis of peroperative BMI. Key words: body mass index; radical surgery for esophageal carcinoma; early complication