title: Perioperative blood transfusions increases the risk of anastomotic leakage after surgery for GEJ-cancer.
abstract: OBJECTIVE
  To investigate the effect of blood transfusions on the risk of anastomotic leakage (AL) in patients with gastro-esophageal-junction (GEJ) cancer.
  
  
  BACKGROUND
  The incidence of GEJ cancer is increasing in the western world. Surgery is the curative treatment of choice. AL increases mortality and morbidity, and increases the risk cancer reoccurrence. In colo-rectal surgery a relation between AL and blood transfusions have been demonstrated.
  
  
  METHODS
  The risk of AL in relation to blood transfusions was investigated in a cohort study. 253 consecutive patients undergoing surgery for GEJ cancer was included. Data was based on a prospective maintained database and analyzed using logistic regressions models adjusting for multiple confounders.
  
  
  RESULTS
  We found an increased risk of AL when blood was transfused OR: 3.47, (1.51; 7.99). This relation was consistent after adjustment for multiple confounders OR: 4.60, (1.29; 16.4). Increasing number of blood units did not increase risk of AL further.
  
  
  CONCLUSIONS
  We present data demonstrating a strong correlation between receiving blood transfusions and the risk of AL after surgery in GEJ cancers patients.
authors.affiliation: Department of Surgery, Section for Upper Gastrointestinal and Hepato-pancreato-biliary Surgery, Aarhus University Hospital, Denmark. Electronic address: kaafje@rm.dk.
authors.forename: Kaare
authors.initials: K
authors.lastname: Terp Fjederholt
authors.affiliation: Department of Surgical Gastroenterology and Transplantation, Rigshospitalet, Denmark.
authors.forename: Lars Bo
authors.initials: LB
authors.lastname: Svendsen
authors.affiliation: Department of Surgery, Section for Upper Gastrointestinal and Hepato-pancreato-biliary Surgery, Aarhus University Hospital, Denmark.
authors.forename: Frank Viborg
authors.initials: FV
authors.lastname: Mortensen
mesh_terms: D000368:Aged; D057868:Anastomotic Leak / Q000453:epidemiology* / Q000209:etiology*; D015331:Cohort Studies; D004938:Esophageal Neoplasms / Q000601:surgery*; D004943:Esophagogastric Junction / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D018570:Risk Assessment; D013274:Stomach Neoplasms / Q000601:surgery*; D065227:Transfusion Reaction