Topic
Leak
About: Leak is a research topic. Over the lifetime, 7981 publications have been published within this topic receiving 72419 citations. The topic is also known as: leakage & leaking.
Papers published on a yearly basis
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Papers
TL;DR: Vigilant follow-up during the first 30 days is critical to avoid catastrophe, because most leaks will happen after patient discharge, and adopting the use of a 40-Fr or larger bougie may decrease the risk of leak.
Abstract: Sleeve gastrectomy has become a popular stand-alone bariatric procedure with comparable weight loss and resolution of comorbidities to that of laparoscopic gastric bypass. The simplicity of the procedure and the decreased long-term risk profile make this surgery more appealing. Nonetheless, the ever present risk of a staple-line leak is still of great concern and needs further investigation. An electronic literature search of MEDLINE database plus manual reference checks of articles published on laparoscopic sleeve gastrectomy for morbid obesity and its complications was completed. Keywords used in the search were “sleeve gastrectomy” OR “gastric sleeve” AND “leak.” We analyzed 29 publications, including 4,888 patients. We analyzed the frequency of leak after sleeve gastrectomy and its associated risks of causation. The risk of leak after sleeve gastrectomy in all comers was 2.4%. This risk was 2.9% in the super-obese [body mass index (BMI) > 50 kg/m2] and 2.2% for BMI < 50 kg/m2. Staple height and use of buttressing material did not affect leak rate. The use of a size 40-Fr or greater bougie was associated with a leak rate of 0.6% compared with those who used smaller sizes whose leak rate was 2.8%. Leaks were found at the proximal third of the stomach in 89% of cases. Most leaks were diagnosed after discharge. Endoscopic management is a viable option for leaks and was documented in 11% of cases as successful. Sleeve gastrectomy has become an important surgical option for the treatment of the ever growing morbidly obese population. The risk of leak is low at 2.4%. Attention to detail specifically at the esophagogastric junction cannot be stressed enough. Careful patient selection (BMI < 50 kg/m2) and adopting the use of a 40-Fr or larger bougie may decrease the risk of leak. Vigilant follow-up during the first 30 days is critical to avoid catastrophe, because most leaks will happen after patient discharge.
670 citations
TL;DR: The most current information about the etiology, pathophysiology, clinical presentation, treatment, and outcome of esophagogastrostomy leaks following esophagectomy is summarized.
Abstract: Purpose To summarize the most current information about the etiology, pathophysiology, clinical presentation, treatment, and outcome of esophagogastrostomy leaks following esophagectomy. Method The English language literature was searched by manual methods and MEDLINE for original articles reporting results and complications of esophagectomy. Results Esophagogastrostomy anastomotic leaks cause considerable morbidity and mortality after esophagectomy. Their major etiologic factors are ischemia of the gastric fundus and errors in surgical technique. The clinical presentation of postoperative anastomotic leak ranges from an asymptomatic radiographic finding to a necrotizing thoracic infection. Severity of illness is largely dependent on four factors: gastric viability, the site (thorax or neck) and time of the leak, and its containment by surrounding tissues. Cervical anastomoses have a higher leak rate than thoracic anastomoses, but leaks from thoracic anastomoses are more morbid. Conclusion Leaks from thoracic anastomoses require aggressive surgical treatment. Cervical anastomotic leaks that are truly confined to the neck can usually be managed at the bedside with wound drainage and packing. However, the seriousness of cervical anastomotic leaks should not be underestimated. Some leaks from anastomoses constructed in the neck are, in reality, mediastinal leaks. Selected patients with radiologically detected asymptomatic leaks can be managed conservatively.
539 citations
TL;DR: This paper identifies the state-of-the-art in leak detection and localization methods and evaluates the capabilities of these techniques in order to identify the advantages and disadvantages of using each leak detection solution.
Abstract: Gas leaks can cause major incidents resulting in both human injuries and financial losses. To avoid such situations, a considerable amount of effort has been devoted to the development of reliable techniques for detecting gas leakage. As knowing about the existence of a leak is not always enough to launch a corrective action, some of the leak detection techniques were designed to allow the possibility of locating the leak. The main purpose of this paper is to identify the state-of-the-art in leak detection and localization methods. Additionally we evaluate the capabilities of these techniques in order to identify the advantages and disadvantages of using each leak detection solution.
531 citations
TL;DR: In this article, the authors examine the currently dentified risk factors contributing to intestinal anastootic breakdown and delineate methods of diagnosis and reatment of this universally dreaded complication.
Abstract: P O s v l l i b t t r t a V s w o nastomotic dehiscence is one of the most dreaded comlications of operations of the large intestine. Breakdown f an anastomosis results in increased morbidity and morality and adversely affects length of stay, cost, and cancer ecurrence. Reported rates of anastomotic dehiscence vary etween 1% and 30%, although experienced colorectal urgeons often quote 3% to 6% as an acceptable overall eakage rate(Table 1). Despite a paucity of prospective andomized data, intuitively it would appear that emergent perations are at greater risk for anastomotic breakdown han those procedures performed electively. Confounding he issue is that there are differing opinions as to what risk actors have been proved to predict anastomotic dehisence. The aim of this review is to examine the currently dentified risk factors contributing to intestinal anastootic breakdown and delineate methods of diagnosis and reatment of this universally dreaded complication.
486 citations
TL;DR: Anastomotic leak after esophagectomy is an important cause of postoperative mortality and increased length of stay, and factors associated with leak on univariate analysis include obesity, heart failure, coronary disease, vascular disease, diabetes, renal insufficiency, tobacco use, procedure duration greater than 5 hours, and type of procedure.
464 citations
Related Topics (5)
Performance Metrics
| Year | Papers |
|---|---|
| 2026 | 2 |
| 2025 | 454 |
| 2024 | 818 |
| 2023 | 836 |
| 2022 | 1,275 |
| 2021 | 298 |