Sebahattin Celik
Yuzuncu Y�±l University, Turkey
Posters & Accepted Abstracts: J Clin Case Rep
Background & Aim: Intraoperative testing of gastrointestinal anastomosis is thought to be effective in assuring anastomotic integrity. In this study we aimed to see if the routine use of methylene blue test identifies any leaks intraoperative and by mending reduce the postoperative proportion of clinical leakages. Methods: This study was a retrospective analysis of consecutive total gastrectomies performed from January 2007 to December 2014 in a university hospital setting by a general surgical group that uses the methylene test exclusively. All operations were performed for gastric or junctional cancers (n=198). All reconstructions (Roux-en Y Esophagojejunostomy) were performed with stapler. The methylene blue test was applied to 108 cases (group-1) via a nasojejunal tube. There was no test performed for the other 90 cases (group-2). Intraoperative leakage rate, postoperative clinical leakage rate, length of hospitalization and also mortality rate were the outcome measures. Results: In total, the postoperative clinical leakage rate was 8.6% .The intraoperative leakage rate was 7.4% in group-1. The postoperative clinical leakage rate was 3.7 % in group-1 while this rate was 14.4% in group-2 (p=0.007). There were no postoperative clinical leaks in cases where an intraoperative leak led to concomitant intraoperative repair. The median length of hospital stay was 6 days in group-1 and 8 days in group-2 (p<0.001). One death was seen in each group. No test related complications were seen. Conclusion: The methylene blue test for Esophagojejunostomy is a safe and reliable method for assessing anastomosis integrity, especially in cases having difficulties during construction of the Esophagojejunostomy.
Journal of Clinical Case Reports received 1345 citations as per Google Scholar report
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