Risk Factor Analysis Of Anastomotic Leakage After Transabdominal Radical Resection For Siewert Type Ⅱ And Ⅲ AEG

Objective:The aim of this study was to investigate the main risk factor of anastomotic leakage after transabdominal radical resection for Siewert type Ⅱ and Ⅲ AEG, providing a theoretical basis for prevention and reduction in the occurrence of the anastomotic leakage.Methods:A retrospective analysis was adopted which involves 903 cases of Siewert typeⅡand Ⅲ AEG who underwent transabdominal radical resection in Shanxi provincial tumor hospital from 2012 January to 2015 January. 13 risk factors containing age, gender,hypertension and diabetes were analyzed by Logistic stepwise regression to check out the major risk factors and further to analyze the correlation between the occurrence of the anastomotic leakage and the major risk factors.Result:The anastomotic leakage occurred in 80 cases from 903 cases, the incidence was8.9%, 7 cases died, the mortality was 8.8%. Logistic stepwise regression analysis showed that the occurrence of anastomotic leakage is closely related to the 3 major risk factors(P<0.05), which include preoperative serum albumin level(OR=3.249, 95%CI1.569~6.725), anastomotic mode(OR=1.795, 95%CI 1.026~3.142) and combined organ resection(OR=1.807, 95%CI 1.069~3.055).Conclusion:The occurrence of anastomotic leakage after transabdominal radical resection for Siewert type Ⅱ and Ⅲ AEG is closely related to the factors of preoperative nutritional status, anastomotic mode and combined organ resection. Therefor, the patients with poor nutritional status and/or combined organ resection should strengthen the management of perioperation period and improve anastomotic mode, in order to prevent and reduce the occurrence of the anastomotic leakage.