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Identification of Risk Factors for Esophagojejunal Anastomotic Leakage after Gastric Surgery

World Journal of Surgery volume 36, pages 1617–1622 (2012)Cite this article

Abstract

Background

Despite the development of the surgical technique and improvements in perioperative management, anastomotic leakage still occurs at esophagojejunal anastomoses after total or proximal gastrectomy. Anastomotic leakage is one of the major complications of concern, chiefly because it can lead to death. The objective of the present study was to identify the risk factors for esophagojejunal anastomotic leakage.

Methods

The study was based on retrospective analysis of the data of a total of 1,640 consecutive patients who underwent total, proximal, or completion gastrectomy, including esophagojejunal anastomosis, between 1999 and 2008.

Results

Thirty-five patients (2.1 %) developed anastomotic leakage. Univariate analysis revealed patient age, pulmonary insufficiency, lymph node dissection, combined resection of other organs, omental resection, operative time, blood loss, intraoperative blood transfusion, and postoperative creatinine level were the significant factors influencing anastomotic leakage. Multivariate analysis identified pulmonary insufficiency and the duration of the operation as the predictors of anastomotic leakage.

Conclusions

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.

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Conflicts of interest

The authors have no direct or indirect commercial and financial incentive associated with publishing the article. There is no potential and real conflicts of interest

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Affiliations

  1. Gastric Surgery Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Yasunori Deguchi, Takeo Fukagawa, Shinji Morita, Masaki Ohashi, Makoto Saka & Hitoshi Katai

Authors
  1. Yasunori Deguchi
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  2. Takeo Fukagawa
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  3. Shinji Morita
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  4. Masaki Ohashi
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  5. Makoto Saka
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  6. Hitoshi Katai
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Correspondence to Takeo Fukagawa.

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Deguchi, Y., Fukagawa, T., Morita, S. et al. Identification of Risk Factors for Esophagojejunal Anastomotic Leakage after Gastric Surgery. World J Surg 36, 1617–1622 (2012). https://doi.org/10.1007/s00268-012-1559-3

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  • DOI: https://doi.org/10.1007/s00268-012-1559-3

Keywords

  • Anastomotic Leakage
  • Great Omentum
  • Proximal Gastrectomy
  • Pulmonary Insufficiency
  • Jejunal Interposition