J Gastric Cancer.  2015 Sep;15(3):167-175. 10.5230/jgc.2015.15.3.167.

Risk Factors for Anastomotic Leakage: A Retrospective Cohort Study in a Single Gastric Surgical Unit

• Kim SH
• Son SY
• Park YS
• Ahn SH
• Park DJ
• Kim HH

• KMID: 2372202
• DOI: http://doi.org/10.5230/jgc.2015.15.3.167

Abstract

PURPOSE
Although several studies report risk factors for anastomotic leakage after gastrectomy for gastric cancer, they have yielded conflicting results. The present retrospective cohort study was performed to identify risk factors that are consistently associated with anastomotic leakage after gastrectomy for stomach cancer.
MATERIALS AND METHODS
All consecutive patients who underwent gastrectomy at a single gastric surgical unit between May 2003 and December 2012 were identified retrospectively. The associations between anastomotic leakage and 23 variables related to patient history, diagnosis, and surgery were assessed and analyzed with logistic regression.
RESULTS
In total, 3,827 patients were included. The rate of anastomotic leakage was 1.88% (72/3,827). Multiple regression analysis showed that male sex (P=0.001), preoperative/intraoperative transfusion (P<0.001), presence of cardiovascular disease (P=0.023), and tumor location (P<0.001) were predictive of anastomotic leakage. Patients with and without leakage did not differ significantly in terms of their 5-year survival: 97.6 vs. 109.5 months (P=0.076).
CONCLUSIONS
Male sex, cardiovascular disease, perioperative transfusion, and tumor location in the upper third of the stomach were associated with an increased risk of anastomotic leakage. Although several studies have reported that an anastomotic complication has a negative impact on long-term survival, this association was not observed in the present study.

Keyword

Stomach neoplasms; Gastrectomy; Complication; Anastomotic leak

MeSH Terms

Anastomotic Leak*
Cardiovascular Diseases
Cohort Studies*
Diagnosis
Gastrectomy
Humans
Logistic Models
Male
Retrospective Studies*
Risk Factors*
Stomach
Stomach Neoplasms

Figure

• 

  Fig. 1 Kaplan-Meier curve presenting the overall survival rate.

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