Esophagojejunal anastomotic leakage following gastrectomy for gastric cancer

被引:70
|
作者
Makuuchi, Rie [1 ]
Irino, Tomoyuki [1 ]
Tanizawa, Yutaka [1 ]
Bando, Etsuro [1 ]
Kawamura, Taiichi [1 ]
Terashima, Masanori [1 ]
机构
[1] Shizuoka Canc Ctr, Div Gastr Surg, 1007 Shimonagakubo, Nagaizumi, Shizuoka 4118777, Japan
关键词
Gastric cancer; Anastomotic leakage; Esophagojejunostomy; Postoperative complication; Review; EXPANDING METAL STENTS; CONTRAST SWALLOW; RISK-FACTORS; ENDOSCOPIC MANAGEMENT; DISTAL GASTRECTOMY; SURGICAL OUTCOMES; CLINICAL-OUTCOMES; ROUTINE ENDOSCOPY; DOUBLE-BLIND; COMPLICATIONS;
D O I
10.1007/s00595-018-1726-8
中图分类号
R61 [外科手术学];
学科分类号
摘要
Esophagojejunal anastomotic leakage (EJAL) is a serious complication of total or proximal gastrectomy for gastric cancer, with a reported incidence of 2.1-14.6% and mortality of up to 50%. EJAL is an independent prognostic factor for the poor survival of gastric cancer patients. Meticulous surgical techniques, experience with anastomotic devices, and a thorough understanding of various risk factors and preventive measures are essential and early diagnosis is critical for preventing EJAL-related death. Patients with suspected EJAL must be evaluated promptly, but contrast swallow is not recommended. There is no standard treatment strategy for EJAL, although conservative treatment with drainage and nutritional support is the most common approach. Effective endoscopic treatments have been reported but need further validation. Surgical treatment is associated with high mortality but should be considered to prevent death from suboptimal EJAL management, for patients with severe sepsis or when conservative treatment has failed.
引用
收藏
页码:187 / 196
页数:10
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