title: Risk factors of esophagojejunal anastomotic leakage after total gastrectomy for gastric cancer.
abstract: OBJECTIVE
  The purpose of this study was to investigate the incidence of esophagojejunal anastomotic leakage (EJAL) after total gastrectomy.
  
  
  METHODS
  Four hundred and four consecutive gastrectomy cases were reviewed to determine the incidence of esophagojejunal anastomotic leakage.
  
  
  RESULTS
  EJAL developed in 33 patients (8.2%). The rate of leakage was found to be significantly related to the preoperative lymphocyte count and serum albumin level. Cases of para-aortic lymph node dissection (D4) had a significantly higher rate (16.1%) of EJAL than in conventional lymph node dissection (D2,3: 5.3%). The left upper abdominal evisceration group demonstrated a significantly higher EJAL rate (20.0%) than the cases without combined resection (4.8%).
  
  
  CONCLUSIONS
  Aggressive surgery for advanced gastric cancer increases the risk of esophagojejunal anastomotic leakage. When aggressive surgery is necessary for curative purposes, meticulous preoperative, intraoperative and postoperative care are indispensable.
authors.affiliation: Department of Surgery, Osaka Medical College, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Isozaki
authors.forename: K
authors.initials: K
authors.lastname: Okajima
authors.forename: T
authors.initials: T
authors.lastname: Ichinona
authors.forename: H
authors.initials: H
authors.lastname: Hara
authors.forename: K
authors.initials: K
authors.lastname: Fujii
authors.forename: E
authors.initials: E
authors.lastname: Nomura
mesh_terms: D000714:Anastomosis, Surgical / Q000009:adverse effects; D004947:Esophagus / Q000601:surgery*; D005119:Extravasation of Diagnostic and Therapeutic Materials; D005260:Female; D005743:Gastrectomy; D006801:Humans; D015994:Incidence; D007583:Jejunum / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology*; D011859:Radiography; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000601:surgery*