RISK-FACTORS OF ESOPHAGOJEJUNAL ANASTOMOTIC LEAKAGE AFTER TOTAL GASTRECTOMY FOR GASTRIC-CANCER

Background/Aims: The purpose of this study was to investigate the inci dence of esophagojejunal anastomotic leakage (EJAL) after total gastre ctomy. Methodology: Four hundred and four consecutive gastrectomy case s were reviewed to determine the incidence of esophagojejunal anastomo tic leakage. Results: EJAL developed in 33 patients (8.2%). The rate o f leakage was found to be significantly related to the preoperative ly mphocyte count and serum albumin. level. Cases of ara-aortic lymph nod e dissection. (D4) had a significantly higher rate (16.1%) of EJAL, th an in conventional lymph node dissection (D2,3: 5.3%). The left upper abdominal evisceration group demonstrated a significantly higher EJAL rate (20.0%) than the cases without combined resection (4.8%). Conclus ion: Aggressive surgery for advanced gastric cancer increases the risk of esophagojejunal anastomotic leakage. When aggressive surgery is ne cessary for curative purposes, meticulous preoperative, intraoperative and postoperative care are indispensable.