Predictive factors and diagnostic significance of CT findings for anastomotic leak after gastric cancer surgery: A retrospective analysis

Background

Anastomotic leak following radical gastrectomy poses a significant risk to patients. Despite previous studies, effective methods for diagnosing anastomotic leaks after gastric cancer surgery remain elusive. In this study, we aimed to assess the overall burden of anastomotic leaks and investigate diagnostic factors, particularly radiological signs on postoperative computed tomography (CT), that may facilitate early detection.

Methods

We included a total of 70 gastric cancer patients who underwent curative gastrectomy and underwent CT examination post-surgery. Among them, 35 patients with anastomotic leak were matched with 35 patients without anastomotic leak. We compared the rates of various types of postoperative complications between the two groups and conducted univariate and multivariate analyses to identify predictive variables for postoperative diagnosis.

Results

Patients with anastomotic leaks experienced significantly longer postoperative hospital stays and higher overall expenditures (p < 0.001). Logistic regression analysis revealed that extraluminal gas at the anastomosis site, fever (T ≥ 38.5°C), and neutrophilia (NE ≥ 78%) on postoperative days 4–7 were independent diagnostic factors for anastomotic leaks (p < 0.05).

Conclusions

The diagnostic factors identified in this study offer valuable insights into early detection of anastomotic leaks. We recommend early CT examination for patients exhibiting consistent fever and neutrophilia between postoperative days 4 and 7 following gastric cancer surgery.