胃癌術后吻合口漏的預防與處理_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

張鵬 ,  陶凱雄

華中科技大學同濟醫學院附屬協和醫院胃腸外科（武漢 430022）;

Corresponding?author：

陶凱雄, Email: kaixiongtao@hust.edu.cn

Keywords：

DOI：

10.7507/1007-9424.202104078

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Citation： 張鵬, 陶凱雄. 胃癌術后吻合口漏的預防與處理. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(6): 717-720. doi: 10.7507/1007-9424.202104078 Copy

1.	中華醫學會外科學分會胃腸外科學組, 中國抗癌協會胃癌專業委員會. 胃癌手術消化道重建機械吻合專家共識. 中國實用外科雜志, 2015, 35(6): 584-592.
2.	中國胃腸腫瘤外科聯盟, 中國抗癌協會胃癌專業委員會. 中國胃腸腫瘤外科術后并發癥診斷登記規范專家共識(2018 版). 中國實用外科雜志, 2018, 38(6): 589-595.
3.	Luo H, Wu L, Huang M, et al. Postoperative morbidity and mortality in patients receiving neoadjuvant chemotherapy for locally advanced gastric cancers: A systematic review and meta-analysis. Medicine (Baltimore), 2018, 97(43): e12932.
4.	Wu L, Ge L, Qin Y, et al. Postoperative morbidity and mortality after neoadjuvant chemotherapy versus upfront surgery for locally advanced gastric cancer: a propensity score matching analysis. Cancer Manag Res, 2019, 11: 6011-6018.
5.	Tonouchi H, Mohri Y, Tanaka K, et al. Diagnostic sensitivity of contrast swallow for leakage after gastric resection. World J Surg, 2007, 31(1): 128-131.
6.	Strauss C, Mal F, Perniceni T, et al. Computed tomography versus water-soluble contrast swallow in the detection of intrathoracic anastomotic leak complicating esophagogastrectomy (Ivor Lewis): a prospective study in 97 patients. Ann Surg, 2010, 251(4): 647-651.
7.	Nederlof N, de Jonge J, de Vringer T, et al. Does routine endoscopy or contrast swallow study after esophagectomy and gastric tube reconstruction change patient management? J Gastrointest Surg, 2017, 21(2): 251-258.
8.	Watanabe M, Miyata H, Gotoh M, et al. Total gastrectomy risk model: data from 20 011 Japanese patients in a nationwide internet-based database. Ann Surg, 2014, 260(6): 1034-1039.
9.	Kurita N, Miyata H, Gotoh M, et al. Risk Model for distal gastrectomy when treating gastric cancer on the basis of data from 33 917 Japanese patients collected using a nationwide web-based data entry system. Ann Surg, 2015, 262(2): 295-303.
10.	王家鑌, 鄭朝輝, 李平, 等. 術前伴發疾病對腹腔鏡輔助全胃切除術后腹部并發癥的影響. 中華消化外科雜志, 2017, 16(3): 275-280.
11.	Lang H, Piso P, Stukenborg C, et al. Management and results of proximal anastomotic leaks in a series of 1 114 total gastrectomies for gastric carcinoma. Eur J Surg Oncol, 2000, 26(2): 168-171.
12.	Ruteg?rd M, Lagergren P, Rouvelas I, et al. Intrathoracic anastomotic leakage and mortality after esophageal cancer resection: a population-based study. Ann Surg Oncol, 2012, 19(1): 99-103.
13.	Kim SH, Son SY, Park YS, et al. Risk factors for anastomotic leakage: a retrospective cohort study in a single gastric surgical unit. J Gastric Cancer, 2015, 15(3): 167-175.
14.	Bickenbach KA, Denton B, Gonen M, et al. Impact of obesity on perioperative complications and long-term survival of patients with gastric cancer. Ann Surg Oncol, 2013, 20(3): 780-787.
15.	Wang JB, Zheng CH, Li P, et al. Effect of comorbidities on postoperative complications in patients with gastric cancer after laparoscopy-assisted total gastrectomy: results from an 8-year experience at a large-scale single center. Surg Endosc, 2017, 31(6): 2651-2660.
16.	Deguchi Y, Fukagawa T, Morita S, et al. Identification of risk factors for esophagojejunal anastomotic leakage after gastric surgery. World J Surg, 2012, 36(7): 1617-1622.
17.	Wang Y, Liu Z, Shan F, et al. Optimal timing to surgery after neoadjuvant chemotherapy for locally advanced gastric cancer. Front Oncol, 2020, 10: 613988.
18.	Sah BK, Chen MM, Yan M, et al. Gastric cancer surgery: Billroth Ⅰ or Billroth Ⅱfor distal gastrectomy? BMC Cancer, 2009, 9: 428.
19.	Jiang L, Yang KH, Chen Y, et al. Systematic review and meta-analysis of the effectiveness and safety of extended lymphadenectomy in patients with resectable gastric cancer. Br J Surg, 2014, 101(6): 595-604.
20.	Sasako M, Sano T, Yamamoto S, et al. D2 lymphadenectomy alone or with para-aortic nodal dissection for gastric cancer. N Engl J Med, 2008, 359(5): 453-462.
21.	Nomura S, Sasako M, Katai H, et al. Decreasing complication rates with stapled esophagojejunostomy following a learning curve. Gastric Cancer, 2000, 3(2): 97-101.
22.	Oh SJ, Hong JJ, Oh CA, et al. Stapling technique for performing Billroth Ⅱanastomosis after distal gastrectomy. J Gastrointest Surg, 2011, 15(7): 1244-1246.
23.	尤承忠, 陳衛東, 范新, 等. 管狀吻合器使用不當致吻合口梗阻35例臨床分析. 中國實用外科雜志, 2016, 36(2): 214-217.
24.	龔磊, 喻晶, 呂真冰, 等. 腹腔鏡胃癌 D2 根治術后吻合口漏的個體化治療. 中國普外基礎與臨床雜志, 2020, 27(7): 831-835.
25.	崔亞平, 趙銳, 王勇, 等. 早期含 ω-3 多不飽和脂肪酸腸內營養聯合靜脈補充丙氨酰谷氨酰胺對胃癌根治術后患者炎癥反應及免疫功能的作用. 中國普外基礎與臨床雜志, 2019, 26(7): 785-791.
26.	Kobayashi D, Ishigure K, Mochizuki Y, et al. Multi-institutional prospective feasibility study to explore tolerability and efficacy of oral nutritional supplements for patients with gastric cancer undergoing gastrectomy (CCOG1301). Gastric Cancer, 2017, 20(4): 718-727.
27.	Boerlage TC, van Hees CL, Huitema AD, et al. Proton pump inhibitor prophylaxis after gastric bypass does not cause hypomagnesemia. Obes Surg, 2016, 26(3): 688-690.
28.	Song W, Chen JH, Zhang XH, et al. Effect of somatostatin in advanced gastric cancer after D2 radical gastrectomy. World J Gastroenterol, 2014, 20(40): 14927-14933.
29.	Kim YJ, Shin SK, Lee HJ, et al. Endoscopic management of anastomotic leakage after gastrectomy for gastric cancer: how efficacious is it? Scand J Gastroenterol, 2013, 48(1): 111-118.
30.	Shim CN, Kim HI, Hyung WJ, et al. Self-expanding metal stents or nonstent endoscopic therapy: which is better for anastomotic leaks after total gastrectomy? Surg Endosc, 2014, 28(3): 833-840.
31.	Pross M, Manger T, Reinheckel T, et al. Endoscopic treatment of clinically symptomatic leaks of thoracic esophageal anastomoses. Gastrointest Endosc, 2000, 51(1): 73-76.
32.	Cipolletta L, Bianco MA, Rotondano G, et al. Endoscopic clipping of perforation following pneumatic dilation of esophagojejunal anastomotic strictures. Endoscopy, 2000, 32(9): 720-722.
33.	Choi SI, Park JC, Jung DH, et al. Efficacy of endoscopic vacuum-assisted closure treatment for postoperative anastomotic leak in gastric cancer. Gut Liver, 2020, 14(6): 746-754.
34.	Hwang JJ, Jeong YS, Park YS, et al. Comparison of endoscopic vacuum therapy and endoscopic stent implantation with self-expandable metal stent in treating postsurgical gastroesophageal leakage. Medicine (Baltimore), 2016, 95(16): e3416.
35.	徐麟, 石鑫, 李蓋天, 等. 損傷控制理論在腹腔膿毒癥中的應用進展. 中國普外基礎與臨床雜志, 2019, 26(2): 253-256.
36.	Wiggins T, Markar SR, Arya S, et al. Anastomotic reinforcement with omentoplasty following gastrointestinal anastomosis: A systematic review and meta-analysis. Surg Oncol, 2015, 24(3): 181-186.
37.	中國抗癌協會胃癌專業委員會, 中華醫學會外科學分會胃腸外科學組. 胃癌圍手術期營養治療中國專家共識(2019 版). 中國實用外科雜志, 2020, 40(2): 145-151.
38.	Blumenthaler AN, Ikoma N, Blum M, et al. Relationship between initial management strategy and survival in patients with gastric outlet obstruction due to gastric cancer. J Surg Oncol, 2020, 122(7): 1373-1382.
39.	Yang W, Chen X, Zhang P, et al. Procalcitonin as an early predictor of intra-abdominal infections following gastric cancer resection. J Surg Res, 2021, 258: 352-361.
40.	Wang J, Yang M, Wang Q, et al. Comparison of early oral feeding with traditional oral feeding after total gastrectomy for gastric cancer: a propensity score matching analysis. Front Oncol, 2019, 9: 1194.
41.	Xu LB, Huang ZX, Zhang HH, et al. Impact of preoperative short-term parenteral nutrition support on the clinical outcome of gastric cancer patients: A propensity score matching analysis. JPEN J Parenter Enteral Nutr, 2020 Jun 17. Online ahead of print.

1. 中華醫學會外科學分會胃腸外科學組, 中國抗癌協會胃癌專業委員會. 胃癌手術消化道重建機械吻合專家共識. 中國實用外科雜志, 2015, 35(6): 584-592.
2. 中國胃腸腫瘤外科聯盟, 中國抗癌協會胃癌專業委員會. 中國胃腸腫瘤外科術后并發癥診斷登記規范專家共識(2018 版). 中國實用外科雜志, 2018, 38(6): 589-595.
3. Luo H, Wu L, Huang M, et al. Postoperative morbidity and mortality in patients receiving neoadjuvant chemotherapy for locally advanced gastric cancers: A systematic review and meta-analysis. Medicine (Baltimore), 2018, 97(43): e12932.
4. Wu L, Ge L, Qin Y, et al. Postoperative morbidity and mortality after neoadjuvant chemotherapy versus upfront surgery for locally advanced gastric cancer: a propensity score matching analysis. Cancer Manag Res, 2019, 11: 6011-6018.
5. Tonouchi H, Mohri Y, Tanaka K, et al. Diagnostic sensitivity of contrast swallow for leakage after gastric resection. World J Surg, 2007, 31(1): 128-131.
6. Strauss C, Mal F, Perniceni T, et al. Computed tomography versus water-soluble contrast swallow in the detection of intrathoracic anastomotic leak complicating esophagogastrectomy (Ivor Lewis): a prospective study in 97 patients. Ann Surg, 2010, 251(4): 647-651.
7. Nederlof N, de Jonge J, de Vringer T, et al. Does routine endoscopy or contrast swallow study after esophagectomy and gastric tube reconstruction change patient management? J Gastrointest Surg, 2017, 21(2): 251-258.
8. Watanabe M, Miyata H, Gotoh M, et al. Total gastrectomy risk model: data from 20 011 Japanese patients in a nationwide internet-based database. Ann Surg, 2014, 260(6): 1034-1039.
9. Kurita N, Miyata H, Gotoh M, et al. Risk Model for distal gastrectomy when treating gastric cancer on the basis of data from 33 917 Japanese patients collected using a nationwide web-based data entry system. Ann Surg, 2015, 262(2): 295-303.
10. 王家鑌, 鄭朝輝, 李平, 等. 術前伴發疾病對腹腔鏡輔助全胃切除術后腹部并發癥的影響. 中華消化外科雜志, 2017, 16(3): 275-280.
11. Lang H, Piso P, Stukenborg C, et al. Management and results of proximal anastomotic leaks in a series of 1 114 total gastrectomies for gastric carcinoma. Eur J Surg Oncol, 2000, 26(2): 168-171.
12. Ruteg?rd M, Lagergren P, Rouvelas I, et al. Intrathoracic anastomotic leakage and mortality after esophageal cancer resection: a population-based study. Ann Surg Oncol, 2012, 19(1): 99-103.
13. Kim SH, Son SY, Park YS, et al. Risk factors for anastomotic leakage: a retrospective cohort study in a single gastric surgical unit. J Gastric Cancer, 2015, 15(3): 167-175.
14. Bickenbach KA, Denton B, Gonen M, et al. Impact of obesity on perioperative complications and long-term survival of patients with gastric cancer. Ann Surg Oncol, 2013, 20(3): 780-787.
15. Wang JB, Zheng CH, Li P, et al. Effect of comorbidities on postoperative complications in patients with gastric cancer after laparoscopy-assisted total gastrectomy: results from an 8-year experience at a large-scale single center. Surg Endosc, 2017, 31(6): 2651-2660.
16. Deguchi Y, Fukagawa T, Morita S, et al. Identification of risk factors for esophagojejunal anastomotic leakage after gastric surgery. World J Surg, 2012, 36(7): 1617-1622.
17. Wang Y, Liu Z, Shan F, et al. Optimal timing to surgery after neoadjuvant chemotherapy for locally advanced gastric cancer. Front Oncol, 2020, 10: 613988.
18. Sah BK, Chen MM, Yan M, et al. Gastric cancer surgery: Billroth Ⅰ or Billroth Ⅱfor distal gastrectomy? BMC Cancer, 2009, 9: 428.
19. Jiang L, Yang KH, Chen Y, et al. Systematic review and meta-analysis of the effectiveness and safety of extended lymphadenectomy in patients with resectable gastric cancer. Br J Surg, 2014, 101(6): 595-604.
20. Sasako M, Sano T, Yamamoto S, et al. D2 lymphadenectomy alone or with para-aortic nodal dissection for gastric cancer. N Engl J Med, 2008, 359(5): 453-462.
21. Nomura S, Sasako M, Katai H, et al. Decreasing complication rates with stapled esophagojejunostomy following a learning curve. Gastric Cancer, 2000, 3(2): 97-101.
22. Oh SJ, Hong JJ, Oh CA, et al. Stapling technique for performing Billroth Ⅱanastomosis after distal gastrectomy. J Gastrointest Surg, 2011, 15(7): 1244-1246.
23. 尤承忠, 陳衛東, 范新, 等. 管狀吻合器使用不當致吻合口梗阻35例臨床分析. 中國實用外科雜志, 2016, 36(2): 214-217.
24. 龔磊, 喻晶, 呂真冰, 等. 腹腔鏡胃癌 D2 根治術后吻合口漏的個體化治療. 中國普外基礎與臨床雜志, 2020, 27(7): 831-835.
25. 崔亞平, 趙銳, 王勇, 等. 早期含 ω-3 多不飽和脂肪酸腸內營養聯合靜脈補充丙氨酰谷氨酰胺對胃癌根治術后患者炎癥反應及免疫功能的作用. 中國普外基礎與臨床雜志, 2019, 26(7): 785-791.
26. Kobayashi D, Ishigure K, Mochizuki Y, et al. Multi-institutional prospective feasibility study to explore tolerability and efficacy of oral nutritional supplements for patients with gastric cancer undergoing gastrectomy (CCOG1301). Gastric Cancer, 2017, 20(4): 718-727.
27. Boerlage TC, van Hees CL, Huitema AD, et al. Proton pump inhibitor prophylaxis after gastric bypass does not cause hypomagnesemia. Obes Surg, 2016, 26(3): 688-690.
28. Song W, Chen JH, Zhang XH, et al. Effect of somatostatin in advanced gastric cancer after D2 radical gastrectomy. World J Gastroenterol, 2014, 20(40): 14927-14933.
29. Kim YJ, Shin SK, Lee HJ, et al. Endoscopic management of anastomotic leakage after gastrectomy for gastric cancer: how efficacious is it? Scand J Gastroenterol, 2013, 48(1): 111-118.
30. Shim CN, Kim HI, Hyung WJ, et al. Self-expanding metal stents or nonstent endoscopic therapy: which is better for anastomotic leaks after total gastrectomy? Surg Endosc, 2014, 28(3): 833-840.
31. Pross M, Manger T, Reinheckel T, et al. Endoscopic treatment of clinically symptomatic leaks of thoracic esophageal anastomoses. Gastrointest Endosc, 2000, 51(1): 73-76.
32. Cipolletta L, Bianco MA, Rotondano G, et al. Endoscopic clipping of perforation following pneumatic dilation of esophagojejunal anastomotic strictures. Endoscopy, 2000, 32(9): 720-722.
33. Choi SI, Park JC, Jung DH, et al. Efficacy of endoscopic vacuum-assisted closure treatment for postoperative anastomotic leak in gastric cancer. Gut Liver, 2020, 14(6): 746-754.
34. Hwang JJ, Jeong YS, Park YS, et al. Comparison of endoscopic vacuum therapy and endoscopic stent implantation with self-expandable metal stent in treating postsurgical gastroesophageal leakage. Medicine (Baltimore), 2016, 95(16): e3416.
35. 徐麟, 石鑫, 李蓋天, 等. 損傷控制理論在腹腔膿毒癥中的應用進展. 中國普外基礎與臨床雜志, 2019, 26(2): 253-256.
36. Wiggins T, Markar SR, Arya S, et al. Anastomotic reinforcement with omentoplasty following gastrointestinal anastomosis: A systematic review and meta-analysis. Surg Oncol, 2015, 24(3): 181-186.
37. 中國抗癌協會胃癌專業委員會, 中華醫學會外科學分會胃腸外科學組. 胃癌圍手術期營養治療中國專家共識(2019 版). 中國實用外科雜志, 2020, 40(2): 145-151.
38. Blumenthaler AN, Ikoma N, Blum M, et al. Relationship between initial management strategy and survival in patients with gastric outlet obstruction due to gastric cancer. J Surg Oncol, 2020, 122(7): 1373-1382.
39. Yang W, Chen X, Zhang P, et al. Procalcitonin as an early predictor of intra-abdominal infections following gastric cancer resection. J Surg Res, 2021, 258: 352-361.
40. Wang J, Yang M, Wang Q, et al. Comparison of early oral feeding with traditional oral feeding after total gastrectomy for gastric cancer: a propensity score matching analysis. Front Oncol, 2019, 9: 1194.
41. Xu LB, Huang ZX, Zhang HH, et al. Impact of preoperative short-term parenteral nutrition support on the clinical outcome of gastric cancer patients: A propensity score matching analysis. JPEN J Parenter Enteral Nutr, 2020 Jun 17. Online ahead of print.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

胃癌術后吻合口漏的預防與處理

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