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.
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.
Authors: Lucas Goense; Pauline M C Stassen; Frank J Wessels; Peter S N van Rossum; Jelle P Ruurda; Maarten S van Leeuwen; Richard van Hillegersberg Journal: Eur Radiol Date: 2017-03-29 Impact factor: 5.315
Authors: Victor D Plat; Boukje T Bootsma; Jennifer Straatman; Janneke van den Bergh; Jan-Hein T M van Waesberghe; Joanna Luttikhold; Micha D P Luyer; Donald L van der Peet; Freek Daams Journal: J Thorac Dis Date: 2020-12 Impact factor: 2.895