Role of Interleukin 6 in Prediction of Early Complications After Minimally Invasive Esophagectomy – A Pilot Study

Abstract INTRODUCTION: Infectious complications following esophagectomy are associated with significant morbidity. Early prediction of these complications may mitigate significant morbidity and mortality METHODS: Patients undergoing minimally invasive esophagectomy for carcinoma esophagus between January 2019 to June 2020 were included in the study. All patients underwent standard preoperative investigations and preparation. Post-operative complications including infectious complications were recorded. Association of postoperative serum interleukin 6 (IL-6) levels with postoperative complications were analysed. RESULTS: A total of twenty-two participants were included in the study (median age; 51 years, 13(%) male). The tumor site was middle 1/3rd of esophagus in 13 (59.1 %), lower 1/3rd of esophagus in 9 (40.9 %). The tumor histology was squamous cell carcinoma in all patients. Eight (36.4 %) patients developed Major complications and five of them developed anastomotic leak. IL 6 levels was significantly higher on POD 3 in patients who developed major complications (p = 0.009) and anastomotic leak (p = 0.031). At receiver operating characteristic curve (ROC curve) analysis an IL 6 cut-off level of 36.4 pg/ml on POD 3 yielded a sensitivity of 87 % and a specificity of 79 % for the prediction of major complication and cut-off level of 44.3 pg/ml on POD 3 yielded a sensitivity of 80 % and a specificity of 82 % for the prediction of anastomotic leak. CONCLUSION: A high postoperative IL 6 level helps in the prediction of major complications and cervical esophagogastric anastomotic leak.