Impact of atrial arrhythmias after esophagectomy on recovery A meta-analysis

Background: Postoperative atrial arrhythmias (PAAs) are common complications after esophagectomy, however research findings are contradicted on the prognosis. Therefore this meta-analysis was conducted to determine whether PAAs after esophagectomy had an impact on prognosis. Methods: Studies comparing prognosis between patients with and without PAAs after esophagectomy were searched in EMBASE, MEDLINE, and the Cochrane Register. Primary prognosis was perioperative mortality, and secondary prognoses were postoperative complications, length of stay (LOS). Results: Ten studies including 2681 patients were included in this analysis, in which 508 patients (18.9%) experienced PAAs. Patients with PAAs resulted in significantly higher perioperative (odds ratio, OR 4.05[95% confidence interval, CI: 2.45-6.70], P=.40) mortality, longer hospital LOS (mean differences, MD: 1.49 [95% CI: 0.32-2.66] days, P=.01), more incidence of pulmonary pneumonia (OR 2.48 [95% CI: 1.71-3.59], P<.00001), and anastomotic leakage (OR 2.37 [95% CI: 1.39-4.03], P<.00001). Conclusions: Atrial arrhythmias (AAs) after esophagectomy are associated with higher perioperative mortality, longer hospital LOS, and more incidences of complications. Therapeutic strategies against PAAs are pending for further researches.