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Risk factors and conservative therapy outcomes of anastomotic leakage after gastrectomy: Experience of 3,926 patients from a single gastric surgical unit

BACKGROUND: Anastomotic leakage (AL) after gastrectomy is one of the severest postoperative complications and is related to increasing mortality. In addition, no consensus guidelines about strategies of AL treatment have been established. This large cohort study aimed to inspect the risk factors and...

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Autores principales: He, Zhongyuan, Liu, Hongda, Zhou, Ling, Li, Qingya, Wang, Linjun, Zhang, Diancai, Xu, Hao, Xu, Zekuan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10050334/
https://www.ncbi.nlm.nih.gov/pubmed/37007118
http://dx.doi.org/10.3389/fonc.2023.1163463
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author He, Zhongyuan
Liu, Hongda
Zhou, Ling
Li, Qingya
Wang, Linjun
Zhang, Diancai
Xu, Hao
Xu, Zekuan
author_facet He, Zhongyuan
Liu, Hongda
Zhou, Ling
Li, Qingya
Wang, Linjun
Zhang, Diancai
Xu, Hao
Xu, Zekuan
author_sort He, Zhongyuan
collection PubMed
description BACKGROUND: Anastomotic leakage (AL) after gastrectomy is one of the severest postoperative complications and is related to increasing mortality. In addition, no consensus guidelines about strategies of AL treatment have been established. This large cohort study aimed to inspect the risk factors and efficacy of the conservative treatment for AL in patients with gastric cancer. METHODS: We reviewed the clinicopathological data of 3,926 gastric cancer patients undergoing gastrectomy between 2014 and 2021. Results contained the rate, risk factors, and conservative therapy outcomes of AL. RESULTS: In total, 80 patients (2.03%, 80/3,926) were diagnosed with AL, and esophagojejunostomy was the most frequent AL site (73.8%, 59/80). Among them, one patient (2.5%, 1/80) died. Multivariate analysis indicated that low albumin concentration (P = 0.001), presence of diabetes (P = 0.025), laparoscopic method (P < 0.001), total gastrectomy (P = 0.003), and proximal gastrectomy (P = 0.002) were predicting factors for AL. The closure rate for the conservative treatment of AL in the first month after AL diagnosis was 83.54% (66/79), and the median time from leakage diagnosis to the closure of leakage was 17 days (interquartile range 11–26 days). Low level of plasma albumin (P = 0.004) was associated with late leakage closures. In terms of 5-year overall survival, no significant difference was observed between patients with and without AL. CONCLUSION: The incidence of AL after gastrectomy is associated with low albumin concentration, diabetes, the laparoscopic method, and extent of resection. The conservative treatment is relatively safe and effective for the AL management in patients after gastric cancer surgery.
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spelling pubmed-100503342023-03-30 Risk factors and conservative therapy outcomes of anastomotic leakage after gastrectomy: Experience of 3,926 patients from a single gastric surgical unit He, Zhongyuan Liu, Hongda Zhou, Ling Li, Qingya Wang, Linjun Zhang, Diancai Xu, Hao Xu, Zekuan Front Oncol Oncology BACKGROUND: Anastomotic leakage (AL) after gastrectomy is one of the severest postoperative complications and is related to increasing mortality. In addition, no consensus guidelines about strategies of AL treatment have been established. This large cohort study aimed to inspect the risk factors and efficacy of the conservative treatment for AL in patients with gastric cancer. METHODS: We reviewed the clinicopathological data of 3,926 gastric cancer patients undergoing gastrectomy between 2014 and 2021. Results contained the rate, risk factors, and conservative therapy outcomes of AL. RESULTS: In total, 80 patients (2.03%, 80/3,926) were diagnosed with AL, and esophagojejunostomy was the most frequent AL site (73.8%, 59/80). Among them, one patient (2.5%, 1/80) died. Multivariate analysis indicated that low albumin concentration (P = 0.001), presence of diabetes (P = 0.025), laparoscopic method (P < 0.001), total gastrectomy (P = 0.003), and proximal gastrectomy (P = 0.002) were predicting factors for AL. The closure rate for the conservative treatment of AL in the first month after AL diagnosis was 83.54% (66/79), and the median time from leakage diagnosis to the closure of leakage was 17 days (interquartile range 11–26 days). Low level of plasma albumin (P = 0.004) was associated with late leakage closures. In terms of 5-year overall survival, no significant difference was observed between patients with and without AL. CONCLUSION: The incidence of AL after gastrectomy is associated with low albumin concentration, diabetes, the laparoscopic method, and extent of resection. The conservative treatment is relatively safe and effective for the AL management in patients after gastric cancer surgery. Frontiers Media S.A. 2023-03-15 /pmc/articles/PMC10050334/ /pubmed/37007118 http://dx.doi.org/10.3389/fonc.2023.1163463 Text en Copyright © 2023 He, Liu, Zhou, Li, Wang, Zhang, Xu and Xu https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
He, Zhongyuan
Liu, Hongda
Zhou, Ling
Li, Qingya
Wang, Linjun
Zhang, Diancai
Xu, Hao
Xu, Zekuan
Risk factors and conservative therapy outcomes of anastomotic leakage after gastrectomy: Experience of 3,926 patients from a single gastric surgical unit
title Risk factors and conservative therapy outcomes of anastomotic leakage after gastrectomy: Experience of 3,926 patients from a single gastric surgical unit
title_full Risk factors and conservative therapy outcomes of anastomotic leakage after gastrectomy: Experience of 3,926 patients from a single gastric surgical unit
title_fullStr Risk factors and conservative therapy outcomes of anastomotic leakage after gastrectomy: Experience of 3,926 patients from a single gastric surgical unit
title_full_unstemmed Risk factors and conservative therapy outcomes of anastomotic leakage after gastrectomy: Experience of 3,926 patients from a single gastric surgical unit
title_short Risk factors and conservative therapy outcomes of anastomotic leakage after gastrectomy: Experience of 3,926 patients from a single gastric surgical unit
title_sort risk factors and conservative therapy outcomes of anastomotic leakage after gastrectomy: experience of 3,926 patients from a single gastric surgical unit
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10050334/
https://www.ncbi.nlm.nih.gov/pubmed/37007118
http://dx.doi.org/10.3389/fonc.2023.1163463
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