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Short-term outcomes of a new gastrointestinal decompression tube combined with conservative treatment in patients with esophagojejunal anastomotic leakage after total gastrectomy

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Abstract

To compare the short-term outcomes of a new gastrointestinal decompression tube combined with conservative treatment in patients with esophagojejunal anastomotic leakage (EJAL) after total gastrectomy. We retrospectively analyzed the data of 81 patients with EJAL who had undergone total gastrectomy and Roux-en-Y reconstruction at Fujian Medical University Union Hospital between January 2014 and December 2021. The patients were divided into experimental (12 patients with new gastrointestinal decompression tube plus conservative treatment) and control (69 patients with conservative treatment) groups, according to the different treatment methods they received. Anatomic defect size linearly correlated with time to clinical success, hospital stay, and hospital cost in the control group. The two groups showed no significant differences in anastomotic defect size, time of defect after surgery, hospitalization cost, and time of antibiotic use. However, the time to clinical success was significantly shorter in the experimental group than in the control group (16.0 ± 8.3 vs. 23.6 ± 17.8, P = 0.04), as was the length of hospital stay (30.1 ± 6.3 vs. 36.8 ± 16.7, P = 0.017). Furthermore, when the defect size was ≥ 4 mm, the time to clinical success, hospital stay, and hospital cost in the experimental group were lower than those in the control group (P < 0.05). Placement of a new gastrointestinal decompression tube is a safe treatment. When the defect size is ≥ 4 mm, the time to clinical success, length of hospital stay, and hospital cost can be reduced.

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Abbreviations

EJAL:

Esophagojejunal anastomotic leakage

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Acknowledgements

This study was completed by all authors.

Funding

Sponsored by Fujian provincial health technology project (2019–1-26); Sponsored by Fujian provincial social development science and technology guiding project, (2022Y01010238).

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Authors and Affiliations

  1. Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, Fujian, China

    Sun-Jian Wang, Qing Duan, Yun-Jing Xue, Li-Lan She & Yu Xia

  2. Department of Gastric Surgery, Fujian Medical University Union Hospital, No.29 Xin quan Road, Fuzhou, 350001, Fujian, China

    Ju-Li Lin

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  1. Sun-Jian Wang
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  2. Qing Duan
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Correspondence to Ju-Li Lin.

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Sun-Jian Wang, Qing Duan, Yun-Jing Xue, Li-Lan She, Yu Xia, Ju-Li Lin have no conflict of interest or financial ties to declare.

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Wang, SJ., Duan, Q., Xue, YJ. et al. Short-term outcomes of a new gastrointestinal decompression tube combined with conservative treatment in patients with esophagojejunal anastomotic leakage after total gastrectomy. Surg Endosc 37, 1799–1805 (2023). https://doi.org/10.1007/s00464-022-09694-w

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