Risk factors of esophagojejunal anastomotic leakage after total gastrectomy for gastric cancer.

Abstract

BACKGROUND/AIMS:

The purpose of this study was to investigate the incidence of esophagojejunal anastomotic leakage (EJAL) after total gastrectomy.

METHODOLOGY:

Four hundred and four consecutive gastrectomy cases were reviewed to determine the incidence of esophagojejunal anastomotic leakage.

RESULTS:

EJAL developed in 33 patients (8.2%). The rate of leakage was found to be significantly related to the preoperative lymphocyte count and serum albumin level. Cases of para-aortic lymph node dissection (D4) had a significantly higher rate (16.1%) of EJAL than in conventional lymph node dissection (D2,3: 5.3%). The left upper abdominal evisceration group demonstrated a significantly higher EJAL rate (20.0%) than the cases without combined resection (4.8%).

CONCLUSION:

Aggressive surgery for advanced gastric cancer increases the risk of esophagojejunal anastomotic leakage. When aggressive surgery is necessary for curative purposes, meticulous preoperative, intraoperative and postoperative care are indispensable.

• Authors: H Isozaki, K Okajima, T Ichinona, H Hara, K Fujii, E Nomura
• Journal: Hepato-gastroenterology (Hepatogastroenterology) 1997 Sep-Oct Vol. 44 Issue 17 Pg. 1509-12 ISSN: 0172-6390 [Print] Greece
• PMID: 9356881 (Publication Type: Journal Article)

Topics

• Anastomosis, Surgical (adverse effects)
• Esophagus (surgery)
• Extravasation of Diagnostic and Therapeutic Materials
• Female
• Gastrectomy
• Humans
• Incidence
• Jejunum (surgery)
• Male
• Middle Aged
• Postoperative Complications (diagnostic imaging, epidemiology)
• Radiography
• Risk Factors
• Stomach Neoplasms (surgery)