The importance of radiological controls of anastomoses after upper gastrointestinal tract surgery - a retrospective cohort study.

INTRODUCTION: This study was designed to analyze whether routine radiological controls of anastomoses in the upper gastrointestinal tract an early detection of anastomotic leaks.

PATIENTS AND METHODS: 135 patients who underwent upper gastrointestinal tract surgery were retrospectively analyzed. Patients in the first group (n = 55) underwent routine radiological control of the anastomoses. In the second group (n = 80) the radiological control was only performed in case of clinical symptoms or signs of anastomotic leaks.

RESULTS: The incidence of anastomotic leaks in the patients seen by us was 5.2%, equivalent to 7 of 135 patients In Group 1 leaks were seen in 4 of 55 patients (7,2%) in group 2 leaks were seen in 3 of 80 (3,8%). The radiological control of the anastomoses with contrast swallow showed the leakage in two cases. Twice the results were false negative. The sensitivity of computed tomography was 100%.

DISCUSSION: Routine radiological control of anastomoses with contrast swallow only has low sensitivity. This procedure should not be performed routinely any more.The radiological control should be used in cases with signs of anastomotic leakage or with postoperatively impaired gastrointestinal passage.