Esophagojejunal anastomotic fistula: a major issue after radical total gastrectomy

Imagem de Miniatura
Arquivos
art_BARCHI_Esophagojejunal_anastomotic_fistula_a_major_issue_after_radical_2019.PDF (1 MB)
Citações na Scopus
11
Tipo de produção
article
Data de publicação
2019
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
SPRINGER-VERLAG ITALIA SRL
Autores
Citação
UPDATES IN SURGERY, v.71, n.3, p.429-438, 2019
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Gastric cancer surgery has evolved considerably over the past years, with substantial improvement on outcomes. Meanwhile, esophagojejunal anastomotic fistula (EJF) continues to impair postoperative results. This study aimed to assess EJF regarding its incidence, risk factors, management and the impact on overall survival. We retrospectively analyzed 258 consecutive patients who underwent total or completion gastrectomy for GC from 2009 and 2017. Clinicopathological characteristics analysis was performed comparing patients who developed EJF with patients with other clinical or surgical complications, as well as patients without any postoperative complications. Fifteen (5.8%) patients had EJF and 81 (31.4%) had other complications (including other surgical fistulas). The median time of EJF diagnosis was on the eighth postoperative day (range 3-76). Completion gastrectomy (p = 0.048) and longer hospital stay (p < 0.001) were associated with the occurrence of EJF. The surgical mortality of patients with EJF was higher than in non-EJF patients (26.7% vs. 4.5%; p < 0.001). Nine patients were treated conservatively and six required surgery. The mortality rate of EJF was 11.1% and 50% in patients who underwent conservative and surgical treatment, respectively. Patients with other complications and patients with EJF had worse survival compared to patients without any complication (p = 0.004 and p = 0.013, respectively). Completion gastrectomy is the main risk factor for EJF occurrence. Still, EJF is associated with high postoperative mortality, longer hospital stay and has a negative impact on long-term survival.
Palavras-chave
Stomach neoplasms, Gastrectomy, Postoperative complications, Digestive system fistula
URI
https://observatorio.fm.usp.br/handle/OPI/33485
Referências
  1. Aloia TA, 2014, J SURG ONCOL, V110, P107, DOI 10.1002/jso.23626
  2. Aurello P, 2015, AM SURGEON, V81, P450
  3. Barchi LC, 2019, ABCD-ARQ BRAS CIR DI, V32, DOI 10.1590/0102-672020180001e1425
  4. Barchi LC, 2016, TRANSL GASTROENT HEP, V1, DOI 10.21037/tgh.2016.12.05
  5. Barchi LC, 2016, ABCD-ARQ BRAS CIR DI, V29, P117, DOI 10.1590/0102-6720201600020013
  6. Budisin N, 2001, J SURG ONCOL, V77, P35, DOI 10.1002/jso.1063
  7. Busweiler LAD, 2017, J SURG ONCOL, V115, P738, DOI 10.1002/jso.24562
  8. Carboni F, 2016, J GASTROINTEST ONCOL, V7, P515, DOI 10.21037/jgo.2016.06.02
  9. CHARLSON ME, 1987, J CHRON DIS, V40, P373, DOI 10.1016/0021-9681(87)90171-8
  10. Dasari BVM, 2014, ANN SURG, V259, P852, DOI 10.1097/SLA.0000000000000564
  11. Deguchi Y, 2012, WORLD J SURG, V36, P1617, DOI 10.1007/s00268-012-1559-3
  12. Dindo D, 2004, ANN SURG, V240, P205, DOI 10.1097/01.sla.0000133083.54934.ae
  13. Girard E, 2014, J VISC SURG, V151, P441, DOI 10.1016/j.jviscsurg.2014.10.004
  14. Gong WB, 2017, INT J SURG, V47, P18, DOI 10.1016/j.ijsu.2017.09.019
  15. Hyodo M, 2007, DIGEST SURG, V24, P169, DOI 10.1159/000102100
  16. Irlbeck T, 2017, ANAESTHESIST, V66, P5, DOI 10.1007/s00101-016-0246-4
  17. Japanese Gastric Canc Assoc, 2017, GASTRIC CANCER, V20, P1, DOI 10.1007/s10120-016-0622-4
  18. Kim SH, 2015, J GASTRIC CANCER, V15, P167, DOI 10.5230/jgc.2015.15.3.167
  19. Ramos MFKP, 2019, ABCD-ARQ BRAS CIR DI, V32, DOI 10.1590/0102-672020190001e1435
  20. Ramos MFKP, 2018, INT J SURG, V53, P366, DOI 10.1016/j.ijsu.2018.03.082
  21. Lang H, 2000, EUR J SURG ONCOL, V26, P168, DOI 10.1053/ejso.1999.0764
  22. Li QG, 2013, WORLD J GASTROENTERO, V19, P4060, DOI 10.3748/wjg.v19.i25.4060
  23. Masoomi H, 2011, ARCH SURG-CHICAGO, V146, P1048, DOI 10.1001/archsurg.2011.203
  24. Messager M, 2017, EJSO-EUR J SURG ONC, V43, P258, DOI 10.1016/j.ejso.2016.06.394
  25. Meyer L, 2005, LANGENBECK ARCH SURG, V390, P510, DOI 10.1007/s00423-005-0575-2
  26. Migita K, 2012, J GASTROINTEST SURG, V16, P1659, DOI 10.1007/s11605-012-1932-4
  27. Nomura S, 2000, GASTRIC CANCER, V3, P97, DOI 10.1007/PL00011703
  28. Oh SJ, 2009, J GASTROINTEST SURG, V13, P239, DOI 10.1007/s11605-008-0716-3
  29. Onodera H, 2004, DIGEST SURG, V21, P146, DOI 10.1159/000078381
  30. Pasquer A, 2016, ANN SURG, V264, P823, DOI 10.1097/SLA.0000000000001768
  31. Pournaras DJ, 2018, WORLD J SURG, V42, P2507, DOI 10.1007/s00268-018-4463-7
  32. Ramos MFKP, 2015, ABCD-ARQ BRAS CIR DI, V28, P216, DOI 10.1590/S0102-67202015000300018
  33. Sano T, 2002, BRIT J SURG, V89, P123
  34. Selby LV, 2017, JAMA SURG, V152, P953, DOI 10.1001/jamasurg.2017.1718
  35. Selby LV, 2015, J AM COLL SURGEONS, V220, P863, DOI 10.1016/j.jamcollsurg.2015.01.058
  36. Sierzega M, 2010, BRIT J SURG, V97, P1035, DOI 10.1002/bjs.7038
  37. Takahashi Hitoshi, 2006, Masui, V55, P79
  38. Takeuchi M, 2016, BMC SURG, V16, DOI 10.1186/s12893-016-0168-8
  39. Tu RH, 2017, EJSO-EUR J SURG ONC, V43, P485, DOI 10.1016/j.ejso.2016.11.022
  40. Turkyilmaz A, 2010, SURG LAPARO ENDO PER, V20, P10, DOI 10.1097/SLE.0b013e3181cdebf4
  41. Washington K, 2010, ANN SURG ONCOL, V17, P3077, DOI 10.1245/s10434-010-1362-z
  42. Weidenhagen R, 2008, SURG ENDOSC, V22, P1818, DOI 10.1007/s00464-007-9706-x
  43. Yoo HM, 2011, J SURG ONCOL, V104, P734, DOI 10.1002/jso.22045
  44. Zilberstein B, 2014, ABCD-ARQ BRAS CIR DI, V27, P133, DOI 10.1590/S0102-67202014000200010
  45. Zilberstein B, 2013, ABCD-ARQ BRAS CIR DI, V26, P2, DOI 10.1590/S0102-67202013000100002

Coleções
Artigos e Materiais de Revistas Científicas - FM/MGT
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/24
Artigos e Materiais de Revistas Científicas - LIM/35
Artigos e Materiais de Revistas Científicas - ODS/03