Identification of Risk Factors for Esophagojejunal Anastomotic Leakage after Gastric Surgery

Abstract

To avoid leakage, surgeons should take care in creating the anastomosis in gastrectomy patients, particularly in cases of poor pulmonary function or when the procedure requires a longer operation.

Can the intraoperative leak test prevent postoperative leakage of esophagojejunal anastomosis after total gastrectomy?

“…However, our leakage rate (4.9 %) was not satisfactory compared to the average leakage rate (4.4 %) in Japan [12]. Among our cases treated by highly experienced surgeons, the rate of EJAL was 2.2 %, which was similar to the previous data (1.0 and 2.1 %) reported from Japanese high-volume centers [4,11]. On the other hand, there was a high leakage rate (12 %) in the cases operated on by lessexperienced surgeons.…”

“…Surgical resection with lymphadenectomy is the only curative treatment. Although there have been recent improvements in the surgical techniques and perioperative management, esophagojejunal anastomotic leakage (EJAL) is still one of the most serious complications after total gastrectomy, and the reported incidence of EJAL varies between 0.5 and 11.0 % [2][3][4][5][6][7][8][9][10][11][12][13]. EJAL leads to a poorer quality of life, prolonged hospital stay, and increased costs and mortality [3,5,6,14].…”

Risk Factors for Anastomotic Leakage of Esophagojejunostomy after Laparoscopy-Assisted Total Gastrectomy for Gastric Cancer

“…Although new surgical techniques and devices and improvements in perioperative management have reduced the complication rates in recent years [4][5][6], anastomotic leakage after gastrectomy for gastric cancer remains a significant issue [6,18].…”

Improving the outcomes in gastric cancer surgery

“…Risk factors for anastomotic leakage have been identified in several studies. These include: older age (> 65 years), longer operating time, intra-operative errors, increased blood loss and comorbidities [89][90][91] . When leakage or associated intra-abdominal abscess is suspected clinically by positive peritoneal signs, fever and/or wound infection, further investigation using computed tomography should be prompted.…”