Background: Anastomotic leak (AL) is a serious complication after gastrectomy. It is associated with prolonged hospital stay, greater expenses, and increased risk for 90-day mortality. Currently, there is no consensus regarding the effect of AL on OS in patients with GC undergoing gastrectomy. This study was designed to investigate the effect of AL on long-term survival after gastrectomy for gastric cancer. Methods: PubMed, Embase, Scopus, Google Scholar, and Cochrane Library were queried during the search process. The literature search started in January 2025 and was updated in May 2025. The studies analyzed the impact of AL on long-term survival, with the primary outcome being long-term overall survival. Pooled effect size measures included restricted mean survival time difference (RMSTD), hazard ratio (HR), and 95% confidence intervals (CIs). Results: Ten studies (11,862 patients) were included. Overall, 338 (2.9%) patients experienced AL. The RMSTD analysis indicates that at 12, 24, 36, 48, and 60 months, patients with AL tend to live 1.1, 3.1, 5.2, 8.1, and 10.6 months shorter, respectively, compared to those who did not develop AL. All results were statistically significant withp< 0.0001. The time-dependent HRs analysis for AL versus no AL shows a higher mortality hazard in patients with AL at 12 (HR 1.32, 95% CI 1.11–1.58), 24 (HR 1.61, 95% CI 1.34–1.92), 36 (HR 1.55, 95% CI 1.27–1.91), 48 months (HR 1.22, 95% CI 1.02–1.53), and 60 months (HR 0.79, 95% CI 0.59–1.10). Conclusions: This research appears to indicate a clinical impact of AL on long-term OS after gastrectomy. Patients experiencing AL appear to have an increased risk of mortality within the initial four years of follow-up.
背景：吻合口漏是胃切除术后一种严重的并发症，与住院时间延长、医疗费用增加以及90天死亡率风险上升相关。目前，关于吻合口漏对接受胃切除术的胃癌患者总生存期的影响尚未达成共识。本研究旨在探讨胃癌胃切除术后吻合口漏对长期生存的影响。 方法：检索过程中查询了PubMed、Embase、Scopus、Google Scholar和Cochrane Library数据库。文献检索始于2025年1月，并于2025年5月更新。纳入研究分析了吻合口漏对长期生存的影响，主要结局指标为长期总生存期。汇总效应量指标包括限制性平均生存时间差、风险比及其95%置信区间。 结果：共纳入10项研究（涉及11,862例患者）。总体而言，338例（2.9%）患者发生吻合口漏。限制性平均生存时间差分析显示，在术后12、24、36、48和60个月时，发生吻合口漏的患者比未发生者生存时间分别缩短1.1、3.1、5.2、8.1和10.6个月，所有结果均具有统计学显著性（p<0.0001）。吻合口漏组与非吻合口漏组的时间依赖性风险比分析显示，吻合口漏患者在术后12个月（HR 1.32，95% CI 1.11–1.58）、24个月（HR 1.61，95% CI 1.34–1.92）、36个月（HR 1.55，95% CI 1.27–1.91）和48个月（HR 1.22，95% CI 1.02–1.53）的死亡风险更高，而60个月时风险比无显著差异（HR 0.79，95% CI 0.59–1.10）。 结论：本研究表明吻合口漏对胃切除术后长期总生存期具有临床影响。发生吻合口漏的患者在术后最初四年的随访期内死亡风险显著增加。
肿瘤(癌症)患者之家