Risk Factors for Esophagojejunal Anastomotic Leakage in Gastric Cancer Patients after Total Gastrectomy

Background: Leakage at the esophagojejunal anastomosis site is an important postoperative complica-tion of total gastrectomy. We analyzed our surgical cases to determine the risk factors for esophagojeju-nal anastomotic leakage.Methods: This study included 309 patients who underwent total gastrectomy and esophagojejunal anas-tomosis. The onset of esophagojejunal anastomotic leakage according to age, gender, performance status, American Society of Anesthesiologists classification, body mass index, presence or absence of diabetes, invasion depth, lymph node metastasis, histological type, presence or absence of esophageal infiltration, operative duration, amount of blood loss, experience of blood transfusion, procedural ap-proach, and the prognostic nutritional index was analyzed.Results: Univariate analyses revealed a significant difference in the rate of esophagojejunal anastomotic leakage due to advanced age, male gender, the presence of diabetes, the presence of esophageal infiltra-tion, and blood loss >= 1,100 g. In the multivariate analysis, which included factors identified in the uni-variate analyses, advanced age, male gender, the presence of diabetes, and blood loss >= 1,100 g were identified as independent risk factors for esophagojejunal anastomotic leakage.Conclusions: Advanced age (>= 68 years), male gender, diabetes, and massive blood loss are risk factors