The Effect of Perioperative Hyperglycemia on Anastomotic Leaks After Total Gastrectomy

Esophagojejunostomy anastomosis is used in total gastrectomy surgeries. Anastomotic leakage is a serious complication seen after these surgeries and is associated with increased morbidity and mortality. Patients with older age and comorbidities have a higher risk of death following anastomotic leakage. Perioperative hyperglycemia is frequently observed in patients undergoing major abdominal surgery as a stress response to surgical trauma, leading to surgical complications through mechanisms such as glycogenolysis, lipolysis, gluconeogenesis, decreased insulin sensitivity, and increased insulin resistance. Hyperglycemia is known to increase the risk of postoperative infection, prolong hospital stay, and increase mortality. Additionally, recent studies have shown that it also increases the risk of anastomotic leakage.

Although diabetes mellitus is a known risk factor for anastomotic leaks, there are few studies on the relationship between perioperative hyperglycemia and anastomotic leaks. The primary objective of our study was to demonstrate the relationship between hyperglycemia detected during anastomosis formation in the perioperative period and postoperative anastomotic leaks.