title: The role of upper gastrointestinal swallow study in patients undergoing proximal or total gastrectomy.
abstract: BACKGROUND
  One of the ominous complications following proximal gastrectomy or total gastrectomy is a leak from the esophagogastric or esophagojejunal anastomosis. An upper gastrointestinal swallow study is traditionally performed to confirm the anastomotic patency and lack of any leak before oral feeding can be initiated.
  
  
  OBJECTIVE
  To challenge the routine use of UGISs following proximal or total gastrectomy in order to check the integrity of the gastroesophageal or jejunoesophageal anastomosis.
  
  
  METHODS
  The charts of 99 patients who underwent PG or TG for malignant pathology were retrospectively reviewed. UGISs were performed on day 6 following surgery using a water-soluble material.
  
  
  RESULTS
  The UGISs were normal in 95 patients, with none displaying any complication related to the gastroesophageal or jejunoesophageal anastomosis. All four patients who experienced a leak from the anastomosis had an early stormy postoperative course.
  
  
  CONCLUSIONS
  Routine use of an UGIS to detect a leak following PG orTG is not justified. UGIS should be performed whenever signs of abdominal sepsis develop following this type or surgery.
authors.affiliation: Division of Surgery, Assaf Harofeh Medical Center, Zerifin, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel.
authors.forename: Jeroukhimov
authors.initials: J
authors.lastname: Igor
authors.forename: Natan
authors.initials: N
authors.lastname: Poluksht
authors.forename: Nava
authors.initials: N
authors.lastname: Siegelmann-Danieli
authors.forename: Ron
authors.initials: R
authors.lastname: Lavy
authors.forename: Ilan
authors.initials: I
authors.lastname: Wassermann
authors.forename: Zvi
authors.initials: Z
authors.lastname: Halpern
authors.forename: Ruth
authors.initials: R
authors.lastname: Gold-Deutch
authors.forename: Ariel
authors.initials: A
authors.lastname: Halevy
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects; D057868:Anastomotic Leak / Q000175:diagnosis* / Q000209:etiology; D015331:Cohort Studies; D003679:Deglutition / Q000502:physiology*; D004938:Esophageal Neoplasms / Q000601:surgery; D004947:Esophagus / Q000503:physiopathology / Q000601:surgery*; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000175:diagnosis / Q000209:etiology; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D005746:Gastric Emptying / Q000502:physiology*; D006801:Humans; D007583:Jejunum / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000601:surgery; D016896:Treatment Outcome