Postoperative superior anastomotic leakage classification and treatment strategy for postoperative esophagogastric junction cancer

• Published in: Journal of gastrointestinal oncology 2024-02, Vol.15 (1), p.12-21
• Main Authors: Zhang, Junli, Li, Changzheng, Ma, Pengfei, Cao, Yanghui, Włodarczyk, Janusz, Ibrahim, Mohsen, Liu, Chenyu, Li, Sen, Zhang, Xijie, Han, Guangsen, Zhao, Yuzhou
• Format: Article
• Language: English
• Subjects: Original
• ISSN: 2078-6891; 2219-679X
• DOI: 10.21037/jgo-23-968

At present, anastomotic fistula cannot be avoided after adenocarcinoma of the esophagogastric junction (AEG). Once the anastomotic leakage occurs, the posterior mediastinum and the left thoracic cavity are often seriously infected, which further impairs respiratory and circulatory function, heightening the danger of the disease course. The aim of this study was to identify the characteristics of superior anastomotic leakage after surgery for AEG and recommend corresponding treatment strategies to improve the diagnosis and treatment of superior anastomotic leakage after surgery for AEG. The clinical data of 57 patients with superior anastomotic leakage after surgery for AEG in the Affiliated Cancer Hospital of Zhengzhou University from January 2017 to March 2019 were retrospectively analyzed, including 27 cases referred from external hospitals and 30 cases at the Affiliated Cancer Hospital of Zhengzhou University. According to the diameter and risk level of anastomotic leakage, the high anastomotic leakage is divided into types I, II, III, and IV. Patients with preoperative comorbidities or those treated with the transabdominal approach or laparoscopic surgery often had type I and type II anastomotic leakage; meanwhile, patients with preoperative comorbidities and sacral perforation or those treated with a thoracic and abdominal approach or open surgery often had type III and IV fistula. The difference between types I-II and types III-IV was statistically significant (P