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Endoscopic management of anastomotic leakage after gastrectomy for gastric cancer: how efficacious is it?

 Yu Jin Kim  ;  Sung Kwan Shin  ;  Hyun Jung Lee  ;  Hyun Soo Chung  ;  Yong Chan Lee  ;  Jun Chul Park  ;  Woo Jin Hyung  ;  Sung Hoon Noh  ;  Choong Bae Kim  ;  Sang Kil Lee 
 Scandinavian Journal of Gastroenterology, Vol.48(1) : 111-118, 2013 
Journal Title
 Scandinavian Journal of Gastroenterology 
Issue Date
Adult ; Aged ; Aged, 80 and over ; Anastomotic Leak/etiology ; Anastomotic Leak/pathology ; Anastomotic Leak/surgery* ; Endoscopy* ; Female ; Gastrectomy/adverse effects* ; Humans ; Lymph Node Excision ; Male ; Middle Aged ; Reoperation ; Retrospective Studies ; Stomach Neoplasms/pathology ; Stomach Neoplasms/surgery* ; Surgical Wound Dehiscence/etiology ; Surgical Wound Dehiscence/pathology ; Surgical Wound Dehiscence/surgery* ; Treatment Outcome
anastomotic leak ; endoscopic closure ; gastric cancer ; radical gastrectomy
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.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Kim, Choong Bai(김충배)
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Park, Jun Chul(박준철) ORCID logo https://orcid.org/0000-0001-8018-0010
Shin, Sung Kwan(신성관) ORCID logo https://orcid.org/0000-0001-5466-1400
Lee, Sang Kil(이상길) ORCID logo https://orcid.org/0000-0002-0721-0364
Lee, Yong Chan(이용찬) ORCID logo https://orcid.org/0000-0001-8800-6906
Chong, Hyon Su(정현수)
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
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