Clinical Implication of Positive Oral Contrast Computed Tomography for the Evaluation of Postoperative Leakage After Gastrectomy for Gastric Cancer

Kim, Yeo Eun; Lim, Joon Seok; Hyung, Woo Jin; Lee, Sang Kil; Choi, Jin Young; Noh, Sung Hoon; Kim, Do Young; Kim, Ki Whang

doi:10.1097/rct.0b013e3181dbe579

Cited by 16 publications

(16 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition to helping to diagnose AL, CT scan with contrast can supply useful information in terms of peri-anastomotic fluid accumulation. In addition, this method can help confirm sepsis resulting from other types of intra-abdominal complications and contribute to decide the necessity of percutaneous drainage ( 43 , 44 ). Along with the development of endoscopic techniques, endoscopy has become a reliable diagnostic tool with almost 95% specificity and sensitivity ( 40 ).…”

Section: Discussionmentioning

confidence: 99%

Risk factors and conservative therapy outcomes of anastomotic leakage after gastrectomy: Experience of 3,926 patients from a single gastric surgical unit

Liu²,

Zhou³

et al. 2023

Front. Oncol.

View full text Add to dashboard Cite

BackgroundAnastomotic leakage (AL) after gastrectomy is one of the severest postoperative complications and is related to increasing mortality. In addition, no consensus guidelines about strategies of AL treatment have been established. This large cohort study aimed to inspect the risk factors and efficacy of the conservative treatment for AL in patients with gastric cancer.MethodsWe reviewed the clinicopathological data of 3,926 gastric cancer patients undergoing gastrectomy between 2014 and 2021. Results contained the rate, risk factors, and conservative therapy outcomes of AL.ResultsIn total, 80 patients (2.03%, 80/3,926) were diagnosed with AL, and esophagojejunostomy was the most frequent AL site (73.8%, 59/80). Among them, one patient (2.5%, 1/80) died. Multivariate analysis indicated that low albumin concentration (P = 0.001), presence of diabetes (P = 0.025), laparoscopic method (P < 0.001), total gastrectomy (P = 0.003), and proximal gastrectomy (P = 0.002) were predicting factors for AL. The closure rate for the conservative treatment of AL in the first month after AL diagnosis was 83.54% (66/79), and the median time from leakage diagnosis to the closure of leakage was 17 days (interquartile range 11–26 days). Low level of plasma albumin (P = 0.004) was associated with late leakage closures. In terms of 5-year overall survival, no significant difference was observed between patients with and without AL.ConclusionThe incidence of AL after gastrectomy is associated with low albumin concentration, diabetes, the laparoscopic method, and extent of resection. The conservative treatment is relatively safe and effective for the AL management in patients after gastric cancer surgery.

show abstract

Section: Discussionmentioning

confidence: 99%

Risk factors and conservative therapy outcomes of anastomotic leakage after gastrectomy: Experience of 3,926 patients from a single gastric surgical unit

Liu²,

Zhou³

et al. 2023

Front. Oncol.

View full text Add to dashboard Cite

show abstract

“…Nevertheless, the generalized use of this examination is debatable (17, 18, 19). Few studies have suggested postoperative CT after gastric cancer surgery, and there are different opinions on the use of oral contrast agents (20, 21). We found there was no apparent benefit of using oral contrast agents to detect anastomotic leakages, as none of the 27 patients who ingested an oral contrast agent 6 hours before the CT scan had an extraluminal contrast leak.…”

Section: Discussionmentioning

confidence: 99%

Radiological appearances of Anastomotic Leakage after Radical Gastrectomy

Sah

Zhang

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Anastomotic leakage is a life-threatening postoperative complication after gastric cancer surgery. Previous studies have not produced effective methods for the early detection of anastomotic leakage. We investigated whether the use of postoperative computed tomography (CT) facilitates the early diagnosis of anastomotic leakage. Methods: Gastric cancer patients who underwent curative gastrectomy and had a CT examination after surgery were included in this study. Propensity score (PS) matching generated 70 cases (35 cases of anastomotic leakage and 35 cases of no anastomotic leak) among 210 eligible cases. Univariate and multivariate analyses were used to identify the predictive variables. Results: Logistic regression analysis revealed that the neutrophilia (NE>85.8%) during postoperative day 1 to day 3 (POD 1-3), fever (body temperature (T) 38.5 C) during postoperative day 4 to day 7 (POD 4-7), and extraluminal gas at the anastomosis site (on CT examination), were the independent predictive factors for an anastomotic leakage (p<0.05). Conclusions: On CT examination, extraluminal gas at the anastomosis site is highly suggestive of anastomotic leakage. Postoperative CT examination is beneficial for the early detection of anastomotic leakage especially in patients with neutrophilia and fever.

show abstract

“…8). Although 99m Tc-diisopropyl iminodiacetic acid scan is not widely used, it can permit a direct visualization of the afferent loop, facilitating the detection of duodenal stump leakage (49).…”

Section: Duodenal Stump Leakagementioning

confidence: 99%

Normal and Abnormal Postoperative Imaging Findings after Gastric Oncologic and Bariatric Surgery

Shin

Kim

2020

Korean J Radiol

View full text Add to dashboard Cite

Gastric cancer is one of the most common malignant tumors and the third leading cause of cancer-related deaths worldwide (1, 2). Among the various treatment options for patients with gastric cancer, surgical resection is the only known curative treatment that achieves long-term survival (3). Recently, an improved understanding of the cause and progression of gastric cancers has led to substantial advances in surgical management. Radical gastrectomy, however, remains a challenging surgical procedure with significant postoperative morbidity (range, 14-43%)

show abstract

Clinical Implication of Positive Oral Contrast Computed Tomography for the Evaluation of Postoperative Leakage After Gastrectomy for Gastric Cancer

Abstract: Positive oral contrast CT can be a reliable tool for diagnosing postoperative leakage that requires further intervention after gastrectomy in gastric cancer patients, and the immediate postoperative outcome may be related with the grade of leaked contrast on CT.

Cited by 16 publications

References 21 publications

Risk factors and conservative therapy outcomes of anastomotic leakage after gastrectomy: Experience of 3,926 patients from a single gastric surgical unit

Risk factors and conservative therapy outcomes of anastomotic leakage after gastrectomy: Experience of 3,926 patients from a single gastric surgical unit

Radiological appearances of Anastomotic Leakage after Radical Gastrectomy

Normal and Abnormal Postoperative Imaging Findings after Gastric Oncologic and Bariatric Surgery

Contact Info

Product

Resources

About