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Clinical implication of positive oral contrast computed tomography for the evaluation of postoperative leakage after gastrectomy for gastric cancer

Authors
 Yeo-Eun Kim  ;  Joon Seok Lim  ;  Woo Jin Hyung  ;  Sang Kil Lee  ;  Jin-Young Choi  ;  Sung Hoon Noh  ;  Myeong-Jin Kim  ;  Ki Whang Kim 
Citation
 JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY, Vol.34(4) : 537-542, 2010 
Journal Title
 JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY 
ISSN
 0363-8715 
Issue Date
2010
MeSH
Administration, Oral ; Adult ; Aged ; Aged, 80 and over ; Contrast Media*/administration & dosage ; Diatrizoate Meglumine*/administration & dosage ; Extravasation of Diagnostic and Therapeutic Materials/diagnostic imaging* ; Extravasation of Diagnostic and Therapeutic Materials/etiology ; Female ; Gastrectomy/adverse effects* ; Hospital Mortality ; Humans ; Length of Stay ; Male ; Middle Aged ; Observer Variation ; Postoperative Complications/diagnostic imaging* ; Postoperative Complications/etiology ; Radiographic Image Enhancement/methods ; Reproducibility of Results ; Retrospective Studies ; Stomach/diagnostic imaging ; Stomach/surgery ; Stomach Neoplasms/surgery*
Keywords
postoperative leakage ; oral contrast ; CT ; gastrectomy ; gastric cancer
Abstract
OBJECTIVE: To evaluate the clinical usefulness of positive oral contrast computed tomography (CT) for the detection of leakage and its relationship with the immediate postoperative outcome after gastrectomy for gastric cancer. METHODS: A total of 210 patients with a clinical suspicion of leakage after gastrectomy for gastric cancer underwent a positive oral contrast CT. Two radiologists retrospectively reviewed the CT images, recorded the presence of extraluminal contrast leakage, and graded the amount of leaked contrast. The rate of postoperative intervention treatment, the length of postoperative hospital stay, and mortality rates were correlated with the presence and grades of leakage. Matching accuracy between CT and other diagnostic studies in detection of leakage was also evaluated. RESULTS: There were 162 patients without extraluminal contrast leakage (77.1%), 13 with grade 1 leakage (6.2%), 19 with grade 2 (9.0%), and 16 with grade 3 (7.6%). Postoperative intervention rate, hospital stay, and mortality were significantly higher in patients with extraluminal contrast than those in patients without extraluminal contrast (P < 0.05). Postoperative hospital stays increased as the leakage grades increased (P = 0.0008). The matching accuracy between CT and other studies was 82.1% (n = 32/39). CONCLUSIONS: Positive oral contrast CT can be a reliable tool for diagnosing postoperative leakage that requires further intervention after gastrectomy in gastric cancer patients, and the immediate postoperative outcome may be related with the grade of leaked contrast on CT
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00004728-201007000-00009&LSLINK=80&D=ovft
DOI
10.1097/RCT.0b013e3181dbe579
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Ki Whang(김기황)
Kim, Myeong Jin(김명진) ORCID logo https://orcid.org/0000-0001-7949-5402
Kim, Yeo Eun(김여은)
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Lee, Sang Kil(이상길) ORCID logo https://orcid.org/0000-0002-0721-0364
Lim, Joon Seok(임준석) ORCID logo https://orcid.org/0000-0002-0334-5042
Choi, Jin Young(최진영) ORCID logo https://orcid.org/0000-0002-9025-6274
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/101419
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