Impact of anastomotic leak on long-term survival in patients undergoing gastrectomy for gastric cancer.

The British Journal of Surgery
S K KamarajahA W Phillips

Abstract

The impact of anastomotic leak (AL) on long-term outcomes after gastrectomy for gastric adenocarcinoma is poorly understood. This study determined whether AL contributes to poor overall survival. Consecutive patients undergoing gastrectomy in a single high-volume unit between 1997 and 2016 were evaluated. Clinicopathological characteristics, oncological and postoperative outcomes were stratified according to whether patients had no AL, non-severe AL or severe AL. Severe AL was defined as anastomotic leakage associated with Clavien-Dindo Grade III-IV complications. The study included 969 patients, of whom 58 (6·0 per cent) developed AL; 15 of the 58 patients developed severe leakage. Severe AL was associated with prolonged hospital stay (median 50, 30 and 13 days for patients with severe AL, non-severe AL and no AL respectively; P < 0·001) and critical care stay (median 11, 0 and 0 days; P < 0·001). There were no significant differences between groups in number of lymph nodes harvested (median 29, 30 and 28; P = 0·528) and R1 resection rates (7, 5 and 6·5 per cent; P = 0·891). Cox multivariable regression analysis showed that severe AL was independently associated with overall survival (hazard ratio 3·96, 95 per cent c.i. 2·11 t...Continue Reading

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Jan 25, 2020·Annals of Surgical Oncology·S K KamarajahA W Phillips

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Citations

Feb 9, 2021·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·Daniel M FoleyJames A Gossage
Mar 6, 2021·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·Chul Kyu RohWoo Jin Hyung
Dec 16, 2021·Journal of Applied Biomaterials & Functional Materials·Zhaoxiong ZhangWeihua Fu

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