Risk Factors for Anastomotic Leakage: A Retrospective Cohort Study in a Single Gastric Surgical Unit

Abstract

PurposeAlthough several studies report risk factors for anastomotic leakage after gastrectomy for gastric cancer, they have yielded conflicting results. The present retrospective cohort study was performed to identify risk factors that are consistently associated with anastomotic leakage after gastrectomy for stomach cancer.Materials and MethodsAll consecutive patients who underwent gastrectomy at a single gastric surgical unit between May 2003 and December 2012 were identified retrospectively. The associations between anastomotic leakage and 23 variables related to patient history, diagnosis, and surgery were assessed and analyzed with logistic regression.ResultsIn total, 3,827 patients were included. The rate of anastomotic leakage was 1.88% (72/3,827). Multiple regression analysis showed that male sex (P=0.001), preoperative/intraoperative transfusion (P<0.001), presence of cardiovascular disease (P=0.023), and tumor location (P<0.001) were predictive of anastomotic leakage. Patients with and without leakage did not differ significantly in terms of their 5-year survival: 97.6 vs. 109.5 months (P=0.076).ConclusionsMale sex, cardiovascular disease, perioperative transfusion, and tumor location in the upper third of the stomach were associated with an increased risk of anastomotic leakage. Although several studies have reported that an anastomotic complication has a negative impact on long-term survival, this association was not observed in the present study.

Semi‐end‐to‐end esophagojejunostomy after laparoscopy‐assisted total gastrectomy better reduces stricture and leakage than the conventional end‐to‐side procedure: A retrospective study

“…Many studies have indicated that EJ stricture and leakage after TG are closely related to the method of EJ . The results of the present study showed that the incidence of EJ‐related complications in the SETE group was lower than that in the ETS group, and the rate of EJ stricture was lower in the SETE group.…”

“…Many studies have indicated that EJ stricture and leakage after TG are closely related to the method of EJ. 12,13,39,40 The results of the present study showed that the incidence of EJ-related complications in the SETE group was lower than that in the ETS group, and the rate of EJ stricture was lower in the SETE group. For the ETS procedure, first, the anastomosis channel and the food channel were not consistent, and the diameter of the circular stapler was not exactly equal to that of the anastomotic stoma.…”

Impact of Anastomotic Leakage on Overall and Disease-free Survival After Surgery for Gastric Carcinoma: A Systematic Review

“…A total of seven articles fulfilled the selection criteria and were included in this systematic review (10)(11)(12)(13)(14)(15)(16). This pool of articles consisted of seven retrospective reports.…”

“…AL was found in 35 patients (6.7%). In the group of patients affected by leakage, the overall mean survival was significantly (13) included a total of 3,827 patients. They reported an AL rate of 1.88%.…”

Gastric fistula secondary to drainage tube penetration: A report of a rare case

“…Gastric fistula, a common complication in gastrointestinal surgery, usually occurs due to the failure of anastomotic healing in gastrointestinal anastomosis and reconstruction, or in the greater curvature of the stomach with a direct injury to the gastric wall followed by splenectomy. The incidence of gastric fistula and patient outcome are dependent on surgery type (1) and clinicopathological factors (2). According to a recent meta-analysis, the incidence and mortality rates following laparoscopic sleeve gastrectomy are ~2.2 and 0.11%, respectively (3), whereas the incidence is ~9.5% following gastrojejunostomy for the treatment of gastric carcinoma (4).…”