Novel abdominal negative pressure lavage-drainage system for anastomotic leakage after R0 resection for gastric cancer.
Age Factors
Aged
Anastomosis, Surgical
/ adverse effects
Anastomotic Leak
/ mortality
Drainage
/ methods
Failure to Rescue, Health Care
/ statistics & numerical data
Feasibility Studies
Female
Gastrectomy
/ adverse effects
Humans
Laparoscopy
/ adverse effects
Male
Malnutrition
/ complications
Middle Aged
Reoperation
/ statistics & numerical data
Retrospective Studies
Stomach Neoplasms
/ surgery
Therapeutic Irrigation
/ methods
Anastomotic leakage
Drainage
Failure-to-rescue
Gastric cancer
Lavage
Journal
World journal of gastroenterology
ISSN: 2219-2840
Titre abrégé: World J Gastroenterol
Pays: United States
ID NLM: 100883448
Informations de publication
Date de publication:
14 Jan 2019
14 Jan 2019
Historique:
received:
31
10
2018
revised:
09
12
2018
accepted:
19
12
2018
entrez:
24
1
2019
pubmed:
24
1
2019
medline:
20
2
2019
Statut:
ppublish
Résumé
Anastomotic leakage (AL) is a severe complication associated with high morbidity and mortality after radical gastrectomy (RG) for gastric cancer (GC). We hypothesized that a novel abdominal negative pressure lavage-drainage system (ANPLDS) can effectively reduce the failure-to-rescue (FTR) and the risk of reoperation, and it is a feasible management for AL. To report our institution's experience with a novel ANPLDS for AL after RG for GC. The study enrolled 4173 patients who underwent R0 resection for GC at our institution between June 2009 and December 2016. ANPLDS was routinely used for patients with AL after January 2014. Characterization of patients who underwent R0 resection was compared between different study periods. AL rates and postoperative outcome among patients with AL were compared before and after the ANPLDS therapy. We used multivariate analyses to evaluate clinicopathological and perioperative factors for associations with AL and FTR after AL. AL occurred in 83 (83/4173, 2%) patients, leading to 7 deaths. The mean time of occurrence of AL was 5.6 days. The AL rate was similar before (2009-2013, period 1) and after (2014-2016, period 2) the implementation of the ANPLDS therapy (1.7% Our experience demonstrates that ANPLDS is a feasible management for AL after RG for GC.
Sections du résumé
BACKGROUND
BACKGROUND
Anastomotic leakage (AL) is a severe complication associated with high morbidity and mortality after radical gastrectomy (RG) for gastric cancer (GC). We hypothesized that a novel abdominal negative pressure lavage-drainage system (ANPLDS) can effectively reduce the failure-to-rescue (FTR) and the risk of reoperation, and it is a feasible management for AL.
AIM
OBJECTIVE
To report our institution's experience with a novel ANPLDS for AL after RG for GC.
METHODS
METHODS
The study enrolled 4173 patients who underwent R0 resection for GC at our institution between June 2009 and December 2016. ANPLDS was routinely used for patients with AL after January 2014. Characterization of patients who underwent R0 resection was compared between different study periods. AL rates and postoperative outcome among patients with AL were compared before and after the ANPLDS therapy. We used multivariate analyses to evaluate clinicopathological and perioperative factors for associations with AL and FTR after AL.
RESULTS
RESULTS
AL occurred in 83 (83/4173, 2%) patients, leading to 7 deaths. The mean time of occurrence of AL was 5.6 days. The AL rate was similar before (2009-2013, period 1) and after (2014-2016, period 2) the implementation of the ANPLDS therapy (1.7%
CONCLUSION
CONCLUSIONS
Our experience demonstrates that ANPLDS is a feasible management for AL after RG for GC.
Identifiants
pubmed: 30670914
doi: 10.3748/wjg.v25.i2.258
pmc: PMC6337017
doi:
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
258-268Déclaration de conflit d'intérêts
Conflict-of-interest statement: To the best of our knowledge, no conflict of interest exists.
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