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Surgery Today
Published in: Surgery Today 3/2019

01-03-2019 | Review Article

Esophagojejunal anastomotic leakage following gastrectomy for gastric cancer

Authors: Rie Makuuchi, Tomoyuki Irino, Yutaka Tanizawa, Etsuro Bando, Taiichi Kawamura, Masanori Terashima

Published in: Surgery Today | Issue 3/2019

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Abstract

Esophagojejunal anastomotic leakage (EJAL) is a serious complication of total or proximal gastrectomy for gastric cancer, with a reported incidence of 2.1–14.6% and mortality of up to 50%. EJAL is an independent prognostic factor for the poor survival of gastric cancer patients. Meticulous surgical techniques, experience with anastomotic devices, and a thorough understanding of various risk factors and preventive measures are essential and early diagnosis is critical for preventing EJAL-related death. Patients with suspected EJAL must be evaluated promptly, but contrast swallow is not recommended. There is no standard treatment strategy for EJAL, although conservative treatment with drainage and nutritional support is the most common approach. Effective endoscopic treatments have been reported but need further validation. Surgical treatment is associated with high mortality but should be considered to prevent death from suboptimal EJAL management, for patients with severe sepsis or when conservative treatment has failed.
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Metadata
Title
Esophagojejunal anastomotic leakage following gastrectomy for gastric cancer
Authors
Rie Makuuchi
Tomoyuki Irino
Yutaka Tanizawa
Etsuro Bando
Taiichi Kawamura
Masanori Terashima
Publication date
01-03-2019
Publisher
Springer Singapore
Published in
Surgery Today / Issue 3/2019
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-018-1726-8

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