scholarly journals Efficacy of Endoscopic Vacuum-Assisted Closure Treatment for Postoperative Anastomotic Leak in Gastric Cancer

Gut and Liver ◽  
2020 ◽  
Vol 14 (6) ◽  
pp. 746-754
Author(s):  
Soo In Choi ◽  
Jun Chul Park ◽  
Da Hyun Jung ◽  
Sung Kwan Shin ◽  
Sang Kil Lee ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Anastomotic Leak ◽  
Vacuum Assisted Closure ◽  
Postoperative Anastomotic Leak

Tu2018 EFFICACY OF ENDOSCOPIC VACUUM ASSISTED CLOSURE TREATMENT FOR POSTOPERATIVE ANASTOMOTIC LEAK OF GASTRIC CANCER

2019 ◽  
Vol 89 (6) ◽  
pp. AB660
Author(s):  
Jun Chul Park ◽  
Soo In Choi ◽  
Eun Hye Kim ◽  
Sung Kwan Shin ◽  
Sang Kil Lee ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Anastomotic Leak ◽  
Vacuum Assisted Closure ◽  
Postoperative Anastomotic Leak

Stenosis of the celiac trunk is associated with anastomotic leak after Ivor–Lewis esophagectomy

2019 ◽  
Vol 32 (7) ◽  
Author(s):  
S Brinkmann ◽  
D H Chang ◽  
K Kuhr ◽  
A H Hoelscher ◽  
J Spiro ◽  
...  
Keyword(s):  
Risk Factors ◽  
Esophageal Cancer ◽  
Anastomotic Leak ◽  
Preoperative Staging ◽  
Multivariable Analysis ◽  
Celiac Trunk ◽  
Ivor Lewis ◽  
Ivor Lewis Esophagectomy ◽  
Significant Difference ◽  
Postoperative Anastomotic Leak

SUMMARY Transthoracic esophagectomy with gastric tube formation is the surgical treatment of choice for esophageal cancer. The surgical reconstruction induces changes of gastric microcirculation, which are recognized as potential risk factors of anastomotic leak. This prospective observational study investigates the association of celiac trunk (TC) stenosis with postoperative anastomotic leak. One hundred fifty-four consecutive patients with esophageal cancer scheduled for Ivor–Lewis esophagectomy were included. Preoperative staging computed tomography (CT) was used to identify TC stenosis. Any narrowing of the lumen due to atherosclerotic changes was classified as stenosis. Percentage of stenotic changes was calculated using the North American Symptomatic Carotid Endarterectomy Trial formula. Multivariable analysis was used to identify possible risk factors for leak. The overall incidence of TC stenosis was 40.9%. Anastomotic leak was identified in 15 patients (9.7%). Incidence of anastomotic leak in patients with stenosis was 19.4% compared to 2.3% in patients without stenosis. Incidence of stenosis in patients with leak was 86.7% (13 of 15 patients) and significantly higher than 38.8% (54 of 139 patients) in patients without leak (P < 0.001). There was a significant difference in median degree of TC stenosis (50.0% vs 39.4%; P = 0.032) in patients with and without leak. In the multivariable model, TC stenosis was an independent risk factor for anastomotic leak (odds ratio: 5.98, 95% CI: 1.58–22.61). TC stenosis is associated with postoperative anastomotic leak after Ivor–Lewis esophagectomy. Routine assessment of TC for possible stenosis is recommended to identify patients at risk.

891m: The Efficacy of Endoscopic Treatment for the Anastomotic Leak After Gastrectomy in Patients With Gastric Cancer

2010 ◽  
Vol 71 (5) ◽  
pp. AB140
Author(s):  
Yu Jin Kim ◽  
Hyun Soo Chung ◽  
Jun Chul Park ◽  
Sang Kil Lee ◽  
Yong Chan Lee ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Anastomotic Leak ◽  
Endoscopic Treatment

Value of peritoneal drain placement after total gastrectomy for gastric adenocarcinoma: A multi-institutional analysis from the U.S. Gastric Cancer Collaborative.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 131-131
Author(s):  
Gregory C. Dann ◽  
Malcolm Hart Squires ◽  
Lauren McLendon Postlewait ◽  
David A. Kooby ◽  
George A. Poultsides ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Anastomotic Leak ◽  
Total Gastrectomy ◽  
Gastric Adenocarcinoma ◽  
Multivariate Analyses ◽  
Major Complication ◽  
Postoperative Outcomes ◽  
Drain Placement ◽  
The U.S

131 Background: A recent randomized trial of peritoneal drain (PD) placement after pancreaticoduodenectomy concluded that placement of PDs decreased the frequency and severity of complications. The role of PD placement after total gastrectomy for gastric adenocarcinoma (GAC) is not well-established. Methods: Patients who underwent total gastrectomy for GAC at 7 institutions from the U.S. Gastric Cancer Collaborative from 2000-2012 were identified. Univariate and multivariate analyses were performed to evaluate the association of PD placement with postoperative outcomes. Results: 344 patients were identified and anastomotic leak rate was 9%.253 (74%) patients received a PD. Those with PD placed had similar ASA class, tumor size, TNM stage, and need for additional organ resection when compared to their counterparts with no PD. No difference was observed in the rate of any complication (54% vs. 48%;p=0.45), major complication (25% vs. 24%;p=0.90), or 30-day mortality (7% vs. 4%;p=0.51) between the two groups. In addition, no difference in anastomotic leak (9% vs. 10%;p=0.90), need for secondary drainage (10% vs. 9%;p=0.92), or reoperation (13% vs. 8%;p=0.28) was identified. On multivariate analysis, PD placement was not associated with a decrease in frequency or severity of postoperative complications. Subset analysis of patients stratified by whether they underwent concomitant pancreatectomy similarly demonstrated no association of PD placement with reduced complications or mortality. In patients who experienced an anastomotic leak (n=31), placement of PD was similarly not associated with a decrease in complications, need for secondary drainage, or mortality. Conclusions: Peritoneal drain placement after total gastrectomy for adenocarcinoma, regardless of concomitant pancreatectomy, is not associated with a decrease in the frequency and severity of adverse postoperative outcomes, including anastomotic leak and mortality, or decrease in the need for secondary drainage procedures or reoperation. Routine use of peritoneal drains is not warranted.

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