胃癌術後消化管縫合不全の検討

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  • Clinical Analysis of Anastomotic Leakage after Gastrectomy for Gastric Cancer.

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Between September 1986 and May 2000, 1, 388 patients with gastric cancer underwent gastrectomy in our department. We compared the clinicopathological features between the 56 patients with anastomotic leakage (leakage group) and the remaining 1, 332 patients without leakage (control group). In the leakage group, we investigated the clinical course and the risk factors of severe anastomotic leakage by using logistic regression analysis. There were significant correlation between anastomotic leakage and the extent of the gastrectomy, the tumor stage, combined resection of adjacent organs and the amount of blood loss during surgery. From the analysis of the risk factors for major leakage, the odds ratio of a large amount of blood loss and underlying disease were relatively high without significance. In the cases with major leakage, a relatively longer duration of therapy and invasive treatment were required. Three patients with major anastomotic leakage died from pancreatic juice leakage and intraabdominal hemorrhage. Total gastrectomy, advanced stage, combined resection and a large amount of bleeding were considered to be the risk factors for anastomotic leakage.

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