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Routine Radiologic Contrast Agent Examination After Gastrectomy for Gastric Cancer Is Not Useful.
Struecker, Benjamin; Chopra, Sascha; Heilmann, Ann-Christin; Spenke, Johanna; Denecke, Christian; Sauer, Igor M; Bahra, Marcus; Pratschke, Johann; Andreou, Andreas; Biebl, Matthias.
Afiliación
  • Struecker B; Department of Surgery, Campus Charité Mitte and Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany. benjamin.struecker@charite.de.
  • Chopra S; Berlin Institute of Health (BIH), Berlin, Germany. benjamin.struecker@charite.de.
  • Heilmann AC; Department of Surgery, Campus Charité Mitte and Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
  • Spenke J; Department of Surgery, Campus Charité Mitte and Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
  • Denecke C; Department of Surgery, Campus Charité Mitte and Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
  • Sauer IM; Department of Surgery, Campus Charité Mitte and Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
  • Bahra M; Department of Surgery, Campus Charité Mitte and Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
  • Pratschke J; Department of Surgery, Campus Charité Mitte and Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
  • Andreou A; Department of Surgery, Campus Charité Mitte and Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
  • Biebl M; Department of Surgery, Campus Charité Mitte and Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
J Gastrointest Surg ; 21(5): 801-806, 2017 05.
Article en En | MEDLINE | ID: mdl-28205124
Many studies have showed that routine upper gastrointestinal contrast agent examinations (RCE) for testing the patency of the anastomosis after esophagectomy or the stapler line after sleeve gastrectomy cannot be recommended due to low sensitivity. However, the clinical value of RCE after gastrectomy for gastric cancer remains unclear. We have retrospectively analyzed the clinical course of 377 consecutive patients who underwent gastrectomy for gastric cancer in our institution between 2005 and 2015. To date, we have performed a RCE on the fifth postoperative day before removal of the nasogastric tube and return to oral intake. In total, we have observed 14 anastomotic leaks (AL) (4%) after oncologic gastrectomy. Four AL (28.6%) occurred before the scheduled RCE on the fifth postoperative day (POD) and 7 (50%) late AL after POD 5. Three patients (21.4%) without any clinical symptoms were diagnosed by the RCE. Sensitivity of RCE was 50%. A significant percentage of patients with AL was diagnosed by computed tomography (CT) of the abdomen (50%). The standard therapy for AL after gastrectomy was endoscopic stent placement (n = 11), including three cases of stenting after surgical revision. Based on our data, we cannot recommend a RCE after gastrectomy for gastric cancer. The majority of AL occurs before or after a RCE and the sensitivity of the examination is low. In case of clinical suspicion of AL, a CT scan (with oral contrast agent) should be performed. In unclear cases, endoscopy is the preferable method providing the option of direct treatment.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Gástricas / Anastomosis Quirúrgica / Medios de Contraste / Fuga Anastomótica / Gastrectomía Tipo de estudio: Etiology_studies / Observational_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Gastrointest Surg Asunto de la revista: GASTROENTEROLOGIA Año: 2017 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Gástricas / Anastomosis Quirúrgica / Medios de Contraste / Fuga Anastomótica / Gastrectomía Tipo de estudio: Etiology_studies / Observational_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Gastrointest Surg Asunto de la revista: GASTROENTEROLOGIA Año: 2017 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Estados Unidos