Analysis of risk factors and intervention measures of esophagojejunal anastomotic leakage in gastric cancer patients after laparoscopic total gastrectomy
10.19538/j.cjps.issn1005-2208.2019.02.15
- Author:
Jun LUO
1
;
Xin-hua CHEN
2
;
Yue-hong CHEN
2
;
Guo-xin LI
2
;
Jiang YU
2
Author Information
1. Department of General Surgery, Nanfang Hospital, Southern Medical University Guangzhou 510515, China Department of Gastrointestinal Surgery,Peking University Shenzhen Hospital Shenzhen 518036, China
2. Department of General Surgery, Nanfang Hospital, Southern Medical University Guangzhou 510515, China
- Publication Type:Journal Article
- Keywords:
gastric cancer;
laparoscopic total gastrectomy;
esophagojejunal anastomotic leakage;
risk factors;
intervention
- From:
Chinese Journal of Practical Surgery
2019;39(02):168-172
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE: To identify the risk factors of esophagojejunal anastomotic leakage and its intervention measures of gastric cancer patients after laparoscopic total gastrectomy. METHODS: The clinical and follow-up data of 440 gastric cancer patients who underwent laparoscopic total gastrectomy with negative margins at the Department of General Surgery, Nanfang Hospital of Southern Medical University from April 2006 to December 2016 were analyzed retrospectively. Risk factors of esophagojejunal anastomotic leakage and intervention measures of patients were analyzed respectively. RESULTS: Esophagojejunal anastomotic leakage occurred in 12 of 440 patients(2.7%). The leakage was diagnosed at a median of 4(range,1 to 8) days after surgery. Univariate analysis showed that gender, age, neoadjuvant chemotherapy, anastomosis method, combined organ resection, invasion of the esophagus were risk factors affecting esophagojejunal anastomotic leakage after laparoscopic total gastrectomy, with statistically significant differences(P<0.05). Multivariate analysis showed that age, neoadjuvant chemotherapy, anastomosis method, combined organ resection,invasion of the esophagus were independent risk factors affecting esophagojejunal anastomotic leakage after laparoscopic total gastrectomy, with statistically significant differences(P<0.05). CONCLUSION: For the elderly patients, who are older than 65 years old, received neoadjuvant chemotherapy, had tumor invasion of the esophagus, undergone total laparoscopic anastomosis, combined organ resection, when they are treating with laparoscopic total gastrectomy, esophagojejunal anastomosis should be careful about. Esophagojejunal anastomotic leakage can be treated effectively with self-expanding metalstents, but the risk of migration still exists.
