Navigating complexities and considerations for suspected anastomotic leakage in the upper gastrointestinal tract: A state of the art review.
Best Pract Res Clin Gastroenterol
; 70: 101916, 2024 Jun.
Article
en En
| MEDLINE
| ID: mdl-39053974
ABSTRACT
This state-of-the-art review explores the intricacies of anastomotic leaks following oesophagectomy and gastrectomy, crucial surgeries for globally increasing esophageal and gastric cancers. Despite advancements, anastomotic leaks occur in up to 30 % and 10 % of oesophagectomy and gastrectomy cases, respectively, leading to prolonged hospital stays, substantial impact upon short- and long-term health-related quality of life and greater mortality. Recognising factors contributing to leaks, including patient characteristics and surgical techniques, are vital for preoperative risk stratification. Diagnosis is challenging, involving clinical signs, biochemical markers, and various imaging modalities. Management strategies range from non-invasive approaches, including antibiotic therapy and nutritional support, to endoscopic interventions such as stent placement and emerging vacuum-assisted closure devices, and surgical interventions, necessitating timely recognition and tailored interventions. A step-up approach, beginning non-invasively and progressing based on treatment success, is more commonly advocated. This comprehensive review highlights the absence of standardised treatment algorithms, emphasizing the importance of individualised patient-specific management.
Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Esofagectomía
/
Fuga Anastomótica
/
Gastrectomía
Límite:
Humans
Idioma:
En
Revista:
Best Pract Res Clin Gastroenterol
Asunto de la revista:
GASTROENTEROLOGIA
Año:
2024
Tipo del documento:
Article
País de afiliación:
Reino Unido