-Original-

Risk Factors for Esophagojejunal Anastomotic Leakage in Gastric Cancer Patients after Total Gastrectomy

Kentaro Maejima^1,2, Nobuhiko Taniai² and Hiroshi Yoshida³

¹Department of Surgery, Hasuda Hospital, Saitama, Japan
²Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School Musashikosugi Hospital, Kanagawa, Japan
³Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School Hospital, Tokyo, Japan

Background: Leakage at the esophagojejunal anastomosis site is an important postoperative complication of total gastrectomy. We analyzed our surgical cases to determine the risk factors for esophagojejunal anastomotic leakage.
Methods: This study included 309 patients who underwent total gastrectomy and esophagojejunal anastomosis. The onset of esophagojejunal anastomotic leakage according to age, gender, performance status, American Society of Anesthesiologists classification, body mass index, presence or absence of diabetes, invasion depth, lymph node metastasis, histological type, presence or absence of esophageal infiltration, operative duration, amount of blood loss, experience of blood transfusion, procedural approach, and the prognostic nutritional index was analyzed.
Results: Univariate analyses revealed a significant difference in the rate of esophagojejunal anastomotic leakage due to advanced age, male gender, the presence of diabetes, the presence of esophageal infiltration, and blood loss ≥1,100 g. In the multivariate analysis, which included factors identified in the univariate analyses, advanced age, male gender, the presence of diabetes, and blood loss ≥1,100 g were identified as independent risk factors for esophagojejunal anastomotic leakage.
Conclusions: Advanced age (≥68 years), male gender, diabetes, and massive blood loss are risk factors for esophagojejunal anastomotic leakage.

J Nippon Med Sch 2023; 90: 64-68

Keywords
gastric cancer, total gastrectomy, anastomotic leakage

Correspondence to
Kentaro Maejima, Department of Surgery, Hasuda Hospital, 1-1662 Negane, Hasuda City, Saitama 349-0131, Japan
ken3363-attacker@nms.ac.jp

Received, June 24, 2022
Accepted, August 24, 2022