Risk factors for esophagojejunal anastomotic leakage after curative total gastrectomy combined with D2 lymph node dissection for gastric cancer

ObjectiveTo explore the risk factors associated with esophagojejunal anastomotic leakage (EJAL) after curative total gastrectomy combined with D2 lymph node dissection for gastric cancer.MethodsWe reviewed the data for 390 consecutive patients undergoing Roux-en-Y esophagojejunostomy reconstruction after total gastrectomy. Multivariate analysis was performed using a logistic regression model to identify the independent risk factors for EJAL.ResultsOf the 390 patients enrolled in this study, EJAL occurred in 10 patients (2.6%), and one patient (1/10) with EJAL died. Univariate analysis identified age, alcohol consumption, pulmonary insufficiency, and intraoperative blood loss as risk factors for EJAL. Of these four risk factors, age and alcohol consumption were retained as independent risk factors by multivariate analysis.ConclusionSurgeons should be very careful regarding anastomotic leakage after esophagojejunal anastomosis, perioperatively, especially in patients with advanced age and a history of alcohol consumption. Pulmonary insufficiency and intraoperative blood loss, although not identified as independent risk factors, should also be considered.