Gastrointestinal leakageafter gastrectomy for gastric cancer
TANG Yun, LI Rong, CHEN Lin, WEI Bo, WU Xian-sheng
Published 2010-03-25
Cite as Chin J Gen Surg, 2010,25(03): 205-208. DOI: 10.3760/cma.j.issn.1007-631x.2010.03.011
Abstract
:Objective To summarizethe treatment experiences in gastrointestinal leaJcage atter gastrectomy for gastriccancer. Mehods From January 1997 to December 2006 the clinical data of 37 cases ofgastrointestinal leakage including anastomotic leakage in 19 cases and duodenal stumpleakage in 18 after gastrectomy for gastric cancer in People's Liberation Army GeneralHospital were analyzed retrospectively. Results All of the Cases were treated withabdominal drainage,continuous gastrointinal decomnression and parenteral nutritioncombined with enteral nutrition.There were 32 cases receiving glutamine enrichmentnutrition support,31 ases used somatostatin,13 cases received supplemented recombinarlthuman growth hormone.Fistula healed in 21~30 d in 9 cases aftergastrectomy,in the other 24 cases fistula healed in 30-60 d,while it healed in 60~81 d in the remaining 2 cases.Twodied of leakage associated complications after gastrectomy for gastric cancer includinganastomotlc leakage follwing esophagojejunostomy complicated by severe thoracic and lunginfection in one and duodenal stump leakage complicated by severe abdominal cavity sepsisand hemorrhage in the other. Conclusion Patent and effective abdominal cavitydrainage,continuous gastrointestinal decompression,parenteral nutrition combined withenteral nutrition,glutarnine,somatostafin and recombinant human growth hormone arethe'mportant factors for the healing of gastrointestinal leakage after gastrectomy torgastric cancer.
Key words:
Stomach neoplasms; Gastric fistula; Intestinal fistula; Gastrectomy; Nutritional support
Contributor Information
TANG Yun
Department of General Surgery,People's Liberation Army GeneralHospital,Beijing 100853,China
LI Rong
Department of General Surgery,People's Liberation Army GeneralHospital,Beijing 100853,China
CHEN Lin
Department of General Surgery,People's Liberation Army GeneralHospital,Beijing 100853,China
WEI Bo
Department of General Surgery,People's Liberation Army GeneralHospital,Beijing 100853,China
WU Xian-sheng
Department of General Surgery,People's Liberation Army GeneralHospital,Beijing 100853,China