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Routine use of contrast swallow after total gastrectomy and esophagectomy : is it justified?
contrast media
esophagectomy
gastrectomy
multidetector computed tomography
swallows
BACKGROUND: After gastrectomy or esophagectomy, esophagogastrostomy and esophagojejunostomy are commonly used for reconstruction. Water-soluble contrast swallow is often used as a routine screening to exclude anastomotic leakage during the first postoperative week. In this retrospective study, the sensitivity and specificity of oral water-soluble contrast swallow for the detection of anastomotic leakage and its clinical symptoms were analysed. MATERIAL AND METHODS: Records of 104 consecutive total gastrectomies and distal esophagectomies were analysed. In all cases, upper gastrointestinal contrast swallow with the use of a water-soluble contrast agent was performed on the 5th postoperative day. Extravasation of the contrast agent was defined as anastomotic leakage. When anastomotic insufficiency was suspected but no extravasation was present, a computed tomography (CT) scan and upper endoscopy were performed. RESULTS: Oral contrast swallow detected 7 anastomotic leaks. Based on CT-scans and upper endoscopy, the true number of anastomotic leakage was 15. The findings of the oral contrast swallow were falsely positive in 4 and falsely negative in 12 patients, respectively. The sensitivity and specificity of the oral contrast swallow was 20% and 96%, respectively. CONCLUSIONS: Routine radiological contrast swallow following total gastrectomy or distal esophagectomy cannot be recommended. When symptoms of anastomotic leakage are present, a CT-scan and endoscopy are currently the methods of choice.
cris.lastimport.scopus | 2024-04-07T17:33:25Z | |
dc.abstract.en | BACKGROUND: After gastrectomy or esophagectomy, esophagogastrostomy and esophagojejunostomy are commonly used for reconstruction. Water-soluble contrast swallow is often used as a routine screening to exclude anastomotic leakage during the first postoperative week. In this retrospective study, the sensitivity and specificity of oral water-soluble contrast swallow for the detection of anastomotic leakage and its clinical symptoms were analysed. MATERIAL AND METHODS: Records of 104 consecutive total gastrectomies and distal esophagectomies were analysed. In all cases, upper gastrointestinal contrast swallow with the use of a water-soluble contrast agent was performed on the 5th postoperative day. Extravasation of the contrast agent was defined as anastomotic leakage. When anastomotic insufficiency was suspected but no extravasation was present, a computed tomography (CT) scan and upper endoscopy were performed. RESULTS: Oral contrast swallow detected 7 anastomotic leaks. Based on CT-scans and upper endoscopy, the true number of anastomotic leakage was 15. The findings of the oral contrast swallow were falsely positive in 4 and falsely negative in 12 patients, respectively. The sensitivity and specificity of the oral contrast swallow was 20% and 96%, respectively. CONCLUSIONS: Routine radiological contrast swallow following total gastrectomy or distal esophagectomy cannot be recommended. When symptoms of anastomotic leakage are present, a CT-scan and endoscopy are currently the methods of choice. | pl |
dc.contributor.author | El-Sourani, Nader | pl |
dc.contributor.author | Bruns, Helge | pl |
dc.contributor.author | Troja, Achim | pl |
dc.contributor.author | Raab, Hans-Rudolf | pl |
dc.contributor.author | Antolovic, Dalibor | pl |
dc.date.accessioned | 2017-04-24T13:57:38Z | |
dc.date.available | 2017-04-24T13:57:38Z | |
dc.date.issued | 2017 | pl |
dc.date.openaccess | 0 | |
dc.description.accesstime | w momencie opublikowania | |
dc.description.additional | Bibliogr. s. 173 | pl |
dc.description.physical | 170-173 | pl |
dc.description.version | ostateczna wersja wydawcy | |
dc.description.volume | 82 | pl |
dc.identifier.doi | 10.12659/PJR.899951 | pl |
dc.identifier.eissn | 1899-0967 | pl |
dc.identifier.issn | 1733-134X | pl |
dc.identifier.uri | http://ruj.uj.edu.pl/xmlui/handle/item/39679 | |
dc.language | eng | pl |
dc.language.container | eng | pl |
dc.rights | Udzielam licencji. Uznanie autorstwa - Użycie niekomercyjne - Bez utworów zależnych 3.0 Polska | * |
dc.rights.licence | CC-BY-NC-ND | |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/3.0/pl/legalcode | * |
dc.share.type | otwarte czasopismo | |
dc.subject.en | contrast media | pl |
dc.subject.en | esophagectomy | pl |
dc.subject.en | gastrectomy | pl |
dc.subject.en | multidetector computed tomography | pl |
dc.subject.en | swallows | pl |
dc.subtype | Article | pl |
dc.title | Routine use of contrast swallow after total gastrectomy and esophagectomy : is it justified? | pl |
dc.title.journal | Polish Journal of Radiology | pl |
dc.type | JournalArticle | pl |
dspace.entity.type | Publication |