Risk factors and prognostic value of anastomotic leak in gastric cancer patients undergoing total gastrectomy
10.3760/cma.j.issn.1007-631X.2018.10.004
- VernacularTitle:胃癌患者全胃切除术后吻合口瘘的危险因素及其预后
- Author:
Zhenmeng LIN
1
;
Huizhe ZHENG
;
Mingfang YAN
;
Changhua ZHUO
;
Yangming LI
Author Information
1. 福建医科大学附属肿瘤医院胃肠肿瘤外科
- Keywords:
Stomach neoplasms;
Anastomotic leak;
Gastrectomy;
Risk factor;
Prognosis
- From:
Chinese Journal of General Surgery
2018;33(10):817-820
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the risk factors for anastomotic leak after total gastrectomy in gastric cancer patients and its impact on patients survival.Methods A total of 1 547 gastric cancer patients who underwent curative resection between 1999 to 2016 were enrolled.Results The anastomotic leak occurred in 106 of 1 547 patients;and it was happened at a median of (6.0 ± 2.1) day after surgery.The median postoperative hospital stay was (9 ± 3) days for non-anastomotic leak,lower than patients for anastomotic leak with (15 ± 5) days.The anastomotic leak was significantly correlated with age,lung function,BMI,serum albumin,intraoperative blood loss,operative time,smoking and diabetes (P ＜0.05).Multivariable analysis showed that the anastomotic leak was significantly correlated with diabetes,lung function,smoking (P ＜ 0.05).The 30-day mortality with anastomotic leak was lower than patients without leak.The 3'-and 5-year survival rate of patients with anastomotic leak were 53.9％ and 47.7％,significantly lower than those of 69.4％ and 58.5％ without anastomotic leak (P ＜ 0.05).By univariate analysis that BMI,pathological stage,tumor size,serum albumin,anastomotic leak were factors affecting prognosis (P ＜ 0.05).While multivariate analysis showed that anastomotic leakage was independently associated with worse overall survival.Conclusion Anastomotic leakage in patients who underwent total gastrectomy increases the 30-day mortality and associated with poorer 5-year survival.
