Risk factors for esophagojejunal anastomotic leakage in curative total gastrectomy combined with D2 lymph node dissection for gastric cancer: A retrospective cohort study

Abstract

Background This study aimed to explore the risk factors associated with esophagojejunal anastomotic leakage (EJAL) in curative total gastrectomy combined with D2 lymph node dissection for gastric cancer. Methods Consecutive patients receiving Roux-en-Y esophagojejunostomy reconstruction after surgery were reviewed. Multivariate analysis was performed using a logistic regression model to identify independent risk factors for EJAL. Results Of the 390 patients enrolled in this study, EJAL occurred in 10 patients (2.6%). One patient (1/10) with EJAL died. Univariate analysis identified age ( P = 0.025), alcohol consumption ( P = 0.019), pulmonary insufficiency ( P = 0.049), and intraoperative blood loss ( P = 0.015) as risk factors for EJAL. Of these four risk factors, age ( P = 0.043) and alcohol consumption ( P = 0.043) were retained as independent risk factors by multivariate analysis. Conclusions Surgeons should be very careful about anastomotic leakage during the perioperative period, especially in patients with advanced age and a history of alcohol consumption. Pulmonary insufficiency and intraoperative blood loss, although not being identified as independent risk factors, should also be considered.