[The Efficiency of Postoperative Endoscopy for Anastomotic Leakage after Total Gastrectomy]

An 81-year-old man underwent total gastrectomy with Roux-en-Y reconstruction for cardiac cancer in our department. He developed high fever on postoperative day 3, and pathological examination showed WBC and CRP level of 12,000/mL and 29.983mg/dL, respectively. A diagnosis of anastomotic leakage was confirmed using enhanced abdominal CT scanning that demonstrated free air around the esophagojejunalanastomosis after totalgastrectomy. The drainage tube was replaced by a 12 Fr sump tube because of leakage on postoperative day 10. Nasal endoscopy performed on postoperative day 13 revealed anastomotic leakage from the sump tube in the abdominal cavity. Endoscopy performed on postoperative day 20 confirmed the anastomotic leakage as a fistula that allowed air to leak into the abdominal cavity. On postoperative day 28, the sump tube was removed and oralintake was started. In conclusion, postoperative endoscopy might be usefulfor the assessment and drainage of anastomotic leakage.