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- Title
CT findings suggesting anastomotic leak and predicting the recovery period following gastric surgery.
- Authors
Kim, Tae; Kim, Jung; Shin, Cheong-Il; Kim, Se; Han, Joon; Choi, Byung
- Abstract
Objective: To assess diagnostic performance of routine CT for detecting anastomotic leak after gastric surgery, and analyse the relationship between recovery period and CT findings. Methods: We included 179 patients who underwent immediate CT and fluoroscopy after gastric surgery. Two reviewers retrospectively rated the possibility of leak on CT using a five-point scale focused on predefined CT findings. They also evaluated CT findings. Patients were categorised as: Group I, leak on fluoroscopy; Group II, possible leak on CT but negative on fluoroscopy; Group III, no leak. We analysed the relationship between recovery period and group. Results: Area under the curve for detecting leak on CT was 0.886 in R1 and 0.668 in R2 with moderate agreement ( к = 0.482). Statistically common CT findings for leak included discontinuity, large amount of air-fluid and wall thickening at anastomosis site ( p < 0.05). Discontinuity at anastomosis site and a large air-fluid collection were independently associated with leak ( p < 0.05). The recovery period including hospitalisation and postoperative fasting period was longer in Group I than Group II or III ( p < 0.05). Group II showed a longer recovery period than Group III ( p < 0.05). Conclusions: Postoperative routine CT was useful for predicting anastomotic leak using specific findings, and for predicting length of recovery period. Key Points: • Anastomotic leakage remains a significant clinical problem following gastric surgery. • Routine CT without oral contrast is useful for predicting anastomotic leaking. • Wall discontinuity at anastomosis sites was an independent predictor for leaking. • CT is also useful for predicting recovery period following gastric surgery.
- Subjects
COMPUTED tomography; STOMACH surgery complications; SURGICAL anastomosis; FLUOROSCOPY
- Publication
European Radiology, 2015, Vol 25, Issue 7, p1958
- ISSN
0938-7994
- Publication type
Article
- DOI
10.1007/s00330-015-3608-4