Radiological appearances of Anastomotic Leakage after Radical Gastrectomy

Abstract

<jats:p>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&gt;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&lt;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.</jats:p>