title: Endoscopic management of anastomotic leakage after gastrectomy for gastric cancer: how efficacious is it?
abstract: BACKGROUND
  Anastomotic leak is a dreadful complication with a high mortality rate. The authors aimed to evaluate the efficacy of endoscopic closure of anastomotic dehiscence after gastrectomy in patients with gastric cancer.
  
  
  METHODS
  The authors retrospectively reviewed 33 patients with anastomotic leakage who had underdone endoscopic treatment among 5249 patients with gastric cancer who underwent radical total or subtotal gastrectomy. Methods of endoscopic closure included clipping with or without detachable snare, fibrosealant, Histoacryl® or stent insertion. Results of endoscopic treatment were categorized as complete, partial closure and failure.
  
  
  RESULTS
  The size of the tissue defect was the only factor that had statistically significant differences among the cases with complete closure, partial closure and failure (p = 0.005). For tissue defects smaller than 2 cm in size, complete closure was achieved in 19 (73.1%), partial closure in 5 patients (19.2%) and 2 failed (7.6%). For those larger than 2 cm in size, one (14.3%) was completely closed, four (57.1%) were partially closed and two (28.6%) failed.
  
  
  CONCLUSIONS
  Endoscopic treatment for anastomotic dehiscence smaller than 2 cm in size had excellent success rate in this study.
authors.affiliation: Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Yu Jin
authors.initials: YJ
authors.lastname: Kim
authors.forename: Sung Kwan
authors.initials: SK
authors.lastname: Shin
authors.forename: Hyun Jung
authors.initials: HJ
authors.lastname: Lee
authors.forename: Hyun Soo
authors.initials: HS
authors.lastname: Chung
authors.forename: Yong Chan
authors.initials: YC
authors.lastname: Lee
authors.forename: Jun Chul
authors.initials: JC
authors.lastname: Park
authors.forename: Woo Jin
authors.initials: WJ
authors.lastname: Hyung
authors.forename: Sung Hoon
authors.initials: SH
authors.lastname: Noh
authors.forename: Choong Bae
authors.initials: CB
authors.lastname: Kim
authors.forename: Sang Kil
authors.initials: SK
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D004724:Endoscopy; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D013529:Surgical Wound Dehiscence / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome