title: [Predictive factors of esophagojejunal fistula after total gastrectomy in gastric cancer patients].
abstract: BACKGROUND
  The main complication observed after total gastrectomy is the oesophagojejunal anastomosic fistla. Its incidence varies between 7.4% and 11.5%. The mortality after anastomic leafage is high at around 20%, representing 30% and 54% of global mortality after total gastrectomy.
  
  
  OBJECTIVE
  This study aimed to evaluate mortality and morbidity after total gastrectomy and to determine their predictive factor
  
  
  METHODS
  this is retrospective study about 80 cases of total gastrectomy for gastric cancer, collected in the departmentof General Surgery of the University Hospital Habib Thameur Tunis during the period 1 January 1995 to 31 December 2010. Reconstruction of the alimentary tract was achieved by Roux-en-Y-jejunal-loop.
  
  
  RESULTS
  Esophagojejunal anastomotic leeakage developed in 14 patients (17%). In 8 patients treatment of anastomotic leakage consisted of re-operation with surgical drainage and confection of jejunostomy. in one patient treatment required resutre of the anastomosis and drainage of an abscess. In one patient treatment required resuture of the anastomosis and drainage of an abscess. in 5 of the 14 patients with a proven leak of oesophagojejunal anastomosis, conservative treatment with parental alimentation, placement of an irrigation-aspiration system and systemic antibiotics was performed. This treatment was successful in all cases. The presence of anastomic fistula extends the median lenght of post operative stay in the hospital of 20 days compared for the payents withiut fistula.Global mortalilty was 8/80 (10%). After esophagojejunal anastomotic leakage, the mortality was 3/8 (21%).
  
  
  CONCLUSIONS
  Leakage of the oesophago-intestinal anastomosis may occur after total gastrectomy for gastric cancer. it's serious complication contributes to mortality after total gastrectomy. Knowledge of the predective factors of esophagojejunal fistula after total gastrectomy in gastric cancer can decrease its incidence .
authors.forename: A
authors.initials: A
authors.lastname: Ben Maamer
authors.forename: H
authors.initials: H
authors.lastname: Zaafouri
authors.forename: R
authors.initials: R
authors.lastname: Noomene
authors.forename: N
authors.initials: N
authors.lastname: Haoues
authors.forename: A
authors.initials: A
authors.lastname: Bouhafa
authors.forename: A
authors.initials: A
authors.lastname: Oueslati
authors.forename: A
authors.initials: A
authors.lastname: Cherif
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000209:etiology / Q000601:surgery; D004937:Esophageal Fistula / Q000209:etiology* / Q000601:surgery; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000601:surgery*; D055815:Young Adult