Risk factors and laboratory markers used to predict leakage in esophagojejunal anastomotic leakage after total gastrectomy.

Autor:	Çetin DA; Department of Gastroenterological Surgery, Şanlıurfa Training and Research Hospital, Şanlıurfa, Turkey., Gündeş E; Department of Gastroenterological Surgery, Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey., Çiyiltepe H; Department of Gastroenterological Surgery, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey., Aday U; Department of Gastroenterological Surgery, Elazığ Training and Research Hospital, Elazığ, Turkey., Uzun O; Department of Gastroenterological Surgery, Kartal Koşuyolu High Speciality Training and Research Hospital, İstanbul, Turkey., Değer KC; Department of Gastroenterological Surgery, Kartal Koşuyolu High Speciality Training and Research Hospital, İstanbul, Turkey., Duman M; Department of Gastroenterological Surgery, Kartal Koşuyolu High Speciality Training and Research Hospital, İstanbul, Turkey.
Jazyk:	angličtina
Zdroj:	Turkish journal of surgery [Turk J Surg] 2018 Nov 20, pp. 1-6. Date of Electronic Publication: 2018 Nov 20.
DOI:	10.5152/turkjsurg.2018.4117
Abstrakt:	Objective: Esophagojejunal anastomotic leakages, which occur in the reconstruction procedures performed after total or proximal gastrectomy, still account for one of the most significant causes of morbidity and mortality in spite of the developments seen in the perioperative management and surgical techniques in gastric cancer surgery. The aim of the presentstudy was to ascertain the risk factors for Esophagojejunal anastomotic leakages. Materialand Methods: A total of 80 patients with gastric cancer, who had total gastrectomy + D2 lymph node dissection and Esophagojejunal anastomotic between January 2013 and December 2016, were retrospectively evaluated. Patients who did not have anastomotic leakages during their clinical follow-ups were allocated to Group 1, whereasthose who had anastomotic leakages were allocated to Group 2. Results: A total of 58 (72.5%) out of 80 patients were males, whereas 22 (27.5%) were females.The mean age of the patients was 61.2±11.2 years. There were no demographic differences between the groups. Postoperative recurrent fever (p=0.001), C-reactive protein values on postoperative days 3 and 5 (p=0.01), and neutrophil-to-lymphocyte ratio on postoperative day 5 (p=0.022) were found to be statistically significant with regardto Esophagojejunal anastomotic leakages and other postoperative complications. The duration of operation (p=0.032) and combined organ resection (p=0.008) were ascertained as risk factors for Esophagojejunal anastomotic leakages. Conclusion: Surgeons should be careful about Esophagojejunal anastomotic leakages thatare significant postoperative complications seen especially in cases where the duration of operation is prolonged, and additional organ resections are performed. Recurrent fever, high C-reactive protein levels, and neutrophil-to-lymphocyte ratio may serve as warnings for complications in postoperative follow-ups.
Databáze:	MEDLINE
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