Impact of Perioperative Shedding of the Endothelial Glycocalyx on Short-term Postoperative Complication in Patients Undergoing Robot-assisted Esophagectomy

Study Overview
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Brief Summary
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The aim of this study was to determine whether changes in serum levels of syndecan-1 before and after surgery, which is an index related to injury of the endothelial glycocalyx layer, are associated with postoperative short-term complications and mortality in patients undergoing robotic esophagectomy.

Official Title
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Impact of Perioperative Shedding of the Endothelial Glycocalyx on Short-term Postoperative Complication in Patients Undergoing Robot-assisted Esophagectomy

Conditions
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Robotic Esophagectomy

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 1. patients 20 years or older who undergo robotic esophagectomy Exclusion Criteria: Emergency surgery If the subject includes a person who can not read the written consent (eg, illiterate, foreigner, etc.) Chronic kidney disease (eGFR <30 mL / min / 1.73 m2) Pregnant and lactating women Use of oral anticoagulants

Ages Eligible for Study
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Minimum Age: 20 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| patients undergoing robotic esophagectomy<br>Patients 20 years or older who undergo robotic esophagectomy | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| base blood concentration of syndecan-1 | preoperative baseline serum levels of syndecan-1 | within 1 hour before surgery | 
| blood concentration of syndecan-1 at the end of the surgery | blood concentration of syndecan-1 at the end of the surgery | within 5 minutes after the end of surgery (when thd surgical drape is removed) | 
| blood concentration of syndecan-1 at 24 hours after surgery | blood concentration of syndecan-1 at 24 hours after surgery | 24 hours after the end of surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Unanticipated Post-Operative Invasive Procedure (STS GTSD 2.41 #3330) | Indicate if the patient had an unplanned invasive procedure after surgery. Examples includes return to the operating room for a redo surgical procedure, a percutaneous procedure performed at bedside or in the radiology suite, a tracheostomy, and wound opening at bedside. Exclusions: postoperative toilet bronchoscopy, central venous access, arterial line placement, foley catheter placement. | during this 1 day hospital visit. | 
| Anastomotic leak following esophageal surgery(STS GTSD 2.41 #3350) | Indicate if the patient had an anastomotic leak following esophageal surgery. | within 30days after end of surgery | 
| Respiratory Failure(STS GTSD 2.41 #3480) | Indicate whether the patient experienced respiratory failure in the postoperative period requiring mechanical ventilation and/or reintubation. | within 30days after end of surgery | 
| initial ventilatory support greater than 48 hours (STS GTSD 2.41 #3520) | Indicate if the patient initially was ventilated greater than 48 hours in the postoperative period. If the patient is reintubated, select the postoperative event Respiratory Failure and do not select this element even if the reintubation ventilator support is > 48 hours. Ventilator support ends with the removal of the endotracheal tube or if the patient has a tracheostomy tube, until no longer ventilator dependent. | within 30days after end of surgery | 
| pneumonia (STS GTSD 2.41 #3460) | Indicate if the patient experienced pneumonia in the postoperative period. Pneumonia is defined as meeting three of five characteristics: fever (> 100.4 F or 38 C), leukocytosis, CXR with infiltrate, positive culture from sputum, or treatment with antibiotics. | within 30days after end of surgery | 
| renal failure(STS GTSD 2.41 #3810) | Indicate whether the patient had acute renal failure or worsening renal function resulting in any of the following: New requirement for dialysis post-operatively Increase in serum creatinine level 3.0 x greater than baseline serum creatinine level ≥4 mg/dL , with an acute rise of at least 0.5 mg/dl | within 30days after end of surgery | 
| mortality(Status 30 Days after Surgery, STS GTSD 2.41 #3950) | Indicate whether the patient was alive or dead at 30 days post-surgery (whether in the hospital or not). time frame: 30days post-surgery | 30days post-surgery | 
| Acute kidney injury | defined as an absolute increase in serum creatinine level C0.3 mg/dL, a 50% (1.5-fold) increase in serum creatinine level from baseline, or a reduction in urine output (documented oliguria< 0.5 mL/kg/h for 6h) | within 48 h after end of surgery |