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Risk Factors for Esophagojejunal Anastomotic Leakage After Elective Gastrectomy for Gastric Cancer

  • Original Article
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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Objective

The aim of this study was to investigate the correlation between intraoperative anastomotic troubles and the incidence of esophagojejunal anastomotic leakage (EJAL), and to identify risk factors for EJAL after elective gastrectomy for gastric cancer.

Methods

This study reviewed the medical and surgical records of 327 patients who underwent elective gastrectomy followed by esophagojejunostomy. A multivariate analysis was performed to determine the risk factors for EJAL.

Results

An EJAL occurred in 19 patients (5.8 %). A multivariate analysis demonstrated that hemoglobin A1c ≥7.0 % (p < 0.01), chronic renal failure (p < 0.01), proximal gastrectomy (p < 0.05), and anastomotic trouble during construction of the esophagojejunostomy (p < 0.01) were independent predictors for EJAL. Anastomotic trouble during construction of esophagojejunostomy occurred in 20 patients (6.1 %), and EJAL occurred in 6 of these 20 patients (30 %). Four of ten patients (40 %) in whom an incomplete anastomosis was repaired by suturing during surgery had an EJAL, while none of seven patients who underwent re-anastomosis had this complication.

Conclusions

EJAL is strongly associated with intraoperative technical errors. To reduce this complication, proper anastomotic techniques are required. Re-anastomosis should be performed when an incomplete anastomosis is discovered during surgery.

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Authors and Affiliations

  1. Department of Surgery, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8522, Japan

    Kazuhiro Migita, Tomoyoshi Takayama, Sohei Matsumoto, Kohei Wakatsuki, Koji Enomoto, Tetsuya Tanaka, Masahiro Ito & Yoshiyuki Nakajima

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  1. Kazuhiro Migita
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  2. Tomoyoshi Takayama
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  3. Sohei Matsumoto
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  4. Kohei Wakatsuki
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  5. Koji Enomoto
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  6. Tetsuya Tanaka
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  7. Masahiro Ito
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  8. Yoshiyuki Nakajima
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Correspondence to Kazuhiro Migita.

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Migita, K., Takayama, T., Matsumoto, S. et al. Risk Factors for Esophagojejunal Anastomotic Leakage After Elective Gastrectomy for Gastric Cancer. J Gastrointest Surg 16, 1659–1665 (2012). https://doi.org/10.1007/s11605-012-1932-4

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  • DOI: https://doi.org/10.1007/s11605-012-1932-4

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