title: Clinical Outcomes of Postoperative Upper Gastrointestinal Leakage According to Treatment Modality.
abstract: We evaluated the clinical outcomes according to treatment modality for gastrointestinal anastomotic leakage.
  
  
  
  Of the 19,207 patients who underwent gastrectomy for gastric cancer from March 2000 to April 2013, we retrospectively analyzed the 133 cases who developed anastomotic leakage. These patients were treated using endoscopic management, surgery, or conservative management (endoscopic treatment was introduced in 2009). To evaluate the efficacy of endoscopic treatment, we compared the clinical outcomes between the conservative management-only group before 2009 and the conservative or endoscopic management group from 2009; and between the surgical management-only group before 2009 and the surgical or endoscopic management group from 2009.
  
  
  
  Seventy-three were initially managed conservatively, 35 were treated surgically, and 25 were treated using endoscopic procedures. Chronologically comparing each treatment group as 'before 2009' (n = 54) and 'from 2009' (n = 79), there were differences in the length of hospital stay (median 32 versus 27, p = 0.048) and duration of antibiotic use (median 28 versus 20, p = 0.013). Patients who underwent conservative or endoscopic management from 2009 showed a shorter hospital stay, period of fasting, and duration of antibiotic use than patients who underwent only conservative management before 2009. Patients who received surgery or endoscopic management from 2009 showed a shorter hospital stay and duration of antibiotic use than patients who underwent only surgery before 2009.
  
  
  
  Endoscopic management for selected cases can reduce duration of hospital stay and antibiotic administration in the treatment of anastomotic leakage after gastrectomy.
authors.affiliation: Department of Gastroenterology, Asan Medical Center, Asan Digestive Disease Research Institute, University of Ulsan College of Medicine, No. 388-1 Pungnap-2 dong, Songpa-gu, Seoul, 138-736, Korea.
authors.forename: Seohyun
authors.initials: S
authors.lastname: Lee
authors.affiliation: Department of Gastroenterology, Asan Medical Center, Asan Digestive Disease Research Institute, University of Ulsan College of Medicine, No. 388-1 Pungnap-2 dong, Songpa-gu, Seoul, 138-736, Korea.
authors.forename: Ji Yong
authors.initials: JY
authors.lastname: Ahn
authors.affiliation: Department of Gastroenterology, Asan Medical Center, Asan Digestive Disease Research Institute, University of Ulsan College of Medicine, No. 388-1 Pungnap-2 dong, Songpa-gu, Seoul, 138-736, Korea. hwoony@gmail.com.
authors.forename: Hwoon-Yong
authors.initials: HY
authors.lastname: Jung
authors.affiliation: Department of Gastroenterology, Asan Medical Center, Asan Digestive Disease Research Institute, University of Ulsan College of Medicine, No. 388-1 Pungnap-2 dong, Songpa-gu, Seoul, 138-736, Korea.
authors.forename: Jeong Hoon
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Gastroenterology, Asan Medical Center, Asan Digestive Disease Research Institute, University of Ulsan College of Medicine, No. 388-1 Pungnap-2 dong, Songpa-gu, Seoul, 138-736, Korea.
authors.forename: Kwi-Sook
authors.initials: KS
authors.lastname: Choi
authors.affiliation: Department of Gastroenterology, Asan Medical Center, Asan Digestive Disease Research Institute, University of Ulsan College of Medicine, No. 388-1 Pungnap-2 dong, Songpa-gu, Seoul, 138-736, Korea.
authors.forename: Do Hoon
authors.initials: DH
authors.lastname: Kim
authors.affiliation: Department of Gastroenterology, Asan Medical Center, Asan Digestive Disease Research Institute, University of Ulsan College of Medicine, No. 388-1 Pungnap-2 dong, Songpa-gu, Seoul, 138-736, Korea.
authors.forename: Kee Don
authors.initials: KD
authors.lastname: Choi
authors.affiliation: Department of Gastroenterology, Asan Medical Center, Asan Digestive Disease Research Institute, University of Ulsan College of Medicine, No. 388-1 Pungnap-2 dong, Songpa-gu, Seoul, 138-736, Korea.
authors.forename: Ho June
authors.initials: HJ
authors.lastname: Song
authors.affiliation: Department of Gastroenterology, Asan Medical Center, Asan Digestive Disease Research Institute, University of Ulsan College of Medicine, No. 388-1 Pungnap-2 dong, Songpa-gu, Seoul, 138-736, Korea.
authors.forename: Gin Hyug
authors.initials: GH
authors.lastname: Lee
authors.affiliation: Department of Gastroenterology, Asan Medical Center, Asan Digestive Disease Research Institute, University of Ulsan College of Medicine, No. 388-1 Pungnap-2 dong, Songpa-gu, Seoul, 138-736, Korea.
authors.forename: Jin-Ho
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Surgery, Asan Medical Center, Asan Digestive Disease Research Institute, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Beom Su
authors.initials: BS
authors.lastname: Kim
authors.affiliation: Department of Surgery, Asan Medical Center, Asan Digestive Disease Research Institute, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Jeong Hwan
authors.initials: JH
authors.lastname: Yook
authors.affiliation: Department of Surgery, Asan Medical Center, Asan Digestive Disease Research Institute, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Sung Tae
authors.initials: ST
authors.lastname: Oh
authors.affiliation: Department of Surgery, Asan Medical Center, Asan Digestive Disease Research Institute, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Byung Sik
authors.initials: BS
authors.lastname: Kim
mesh_terms: D000368:Aged; D057868:Anastomotic Leak / Q000473:pathology* / Q000628:therapy; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000601:surgery*; D041742:Upper Gastrointestinal Tract / Q000601:surgery*
keywords: Anastomosis; Endoscopy; Gastrectomy; Leak