SEARCHCOHORTsurgery, oncology

cohort·surgery, oncology, gastroenterology, internal medicine, observational study·PMC10050334

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

Frontiers in Oncology · 8 authors, 2 centres

AI SUMMARY

FIDELITY 100%

POPULATION3,926 gastric cancer patients undergoing gastrectomy between 2014 and 2021

INTERVENTIONConservative management for anastomotic leakage after gastrectomy

COMPARISONPatients with and without anastomotic leakage; early vs. late leakage closure groups

This summary was generated by AI from a single paper. It has not been reviewed by a clinician and is not clinical advice. Verify against the source before acting on it.

AGENT 01 · STRUCTURED SUMMARY

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TL;DR

This large retrospective cohort study of 3,926 gastric cancer patients found that low albumin, diabetes, laparoscopic surgery, and certain gastrectomy types were independent risk factors for anastomotic leakage after gastrectomy.

Full summary

516 CHARS

A retrospective cohort study analyzed data from 3,926 gastric cancer patients who had gastrectomy from 2014 to 2021. The overall anastomotic leakage rate was 2.03% (80/3,926), with one leakage-related death (1.25%). Multivariate analysis identified low albumin, diabetes, laparoscopic approach, and total or proximal gastrectomy as independent risk factors for leakage. The findings suggest conservative management is a relatively safe and effective option for most anastomotic leakages after gastric cancer surgery.

PICO

PPOPULATION

3,926 gastric cancer patients undergoing gastrectomy between 2014 and 2021

IINTERVENTION

Conservative management for anastomotic leakage after gastrectomy

OOUTCOME

Incidence, risk factors, and conservative treatment outcomes of anastomotic leakage, including closure rate and time to closure

STUDY TYPE

cohort

SPECIALTY

surgery

SUMMARISED BY

AI pipeline

FIDELITY CHECK

100% · A

ORIGINAL PAPER

PMC10050334

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

Frontiers in Oncology

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ABSTRACT

Abstract 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. Keywords: gastric cancer, anastomotic leakage, gastrectomy, complication, laparoscopic approach

CITATION EXPORT

Zhongyuan He, Hongda Liu, Ling Zhou et al.. Risk factors and conservative therapy outcomes of anastomotic leakage after gastrectomy: Experience of 3,926 patients from a single gastric surgical unit. Frontiers in Oncology. (2023). https://doi.org/10.3389/fonc.2023.1163463

AUTHORS

8 · 2 CENTRES

Zhongyuan He, Hongda Liu, Ling Zhou, Qingya Li, Linjun Wang, Diancai Zhang, Hao Xu, Zekuan Xu

1 Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
2 Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China