Self-expanding plastic stents for the treatment of post-operative esophago-jejuno anastomosis leak. A case series study

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Abstract

Objetive: Self-expandable plastic stents (SEPS) are increasingly being used for treatment of postoperative esophageal leak. This complication occurs in 4-27% of patients after radical gastrectomy, and has a high mortality rate up to 60%. The aim of this study is to evaluate the efficacy of SEPS (Polyflex®) for treatment of post-operative eshopago-jejuno anastomosis leak after radical gastrectomy for gastric cancer. Material and methods: During one year period patients who underwent a radical gastrectomy in our hospital for gastric cancer and developed a postoperative anastomotic leak were prospectively included in the study after signing a consent form, and treated with SEPS placement under endoscopic and fluoroscopic control for leak occlusion. Results: Four patients were included (3 men/1 woman). The mean interval between operation and SEPS placement was 16 days (range: 4-34). SEPS deployment was easily performed in all patients with complete occlusion of esophageal lumen in three patients. In the fourth patient we needed to deploy a second coaxial stent to achieve a complete occlusion of the fistula. SEPS migration did not happen in our series. One patient had already developed a mediastinitis by the time we placed the SEPS and he died 3 days later. Extraction of the SEPS was easily performed 4-8 weeks after deployment. Conclusion: We achieved a complete healing of the anastomotic fistula after radical gastrectomy in 3 out of 4 patients, without major complications related to SEPS. Placement of SEPS is an appealing minimally invasive alternative to surgical repair for patients with postoperative anastomotic leak. Copyright © 2010 Arán Ediciones, S. L.

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Fernández Villaverde, A., Vila, J. J., Vázquez, S., González-Portela, C., De La Iglesia, M., Lozano, M., & Toscano, E. (2010). Self-expanding plastic stents for the treatment of post-operative esophago-jejuno anastomosis leak. A case series study. Revista Espanola de Enfermedades Digestivas, 102(12), 704–710. https://doi.org/10.4321/s1130-01082010001200005

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