RSS-Feed abonnieren
DOI: 10.1055/a-2559-9469
Roux stasis syndrome with a diverticulum: lumen-apposing metal stent placement to straighten the lumen and restore the flow
Roux-en-Y esophagojejunostomy is commonly performed after total gastrectomy, especially in oncological and bariatric surgery. However, it is often associated with complications [1] [2], one of which is Roux stasis syndrome, characterized by symptoms of nausea, vomiting, and postprandial bloating due to impaired digestive flow at the anastomotic site or within the Roux limb [3]. These symptoms can have a significant impact on a patientʼs quality of life and require innovative approaches when conventional treatments fail.
This case presents a patient who developed chronic Roux stasis syndrome three years after undergoing a Roux-en-Y esophagojejunostomy. An excessively long blind jejunal limb had created a diverticulum ([Fig. 1] a), which exacerbated her symptoms due to stasis and misdirected food flow into the diverticulum rather than the lumen. Conservative therapies did not provide adequate relief, so endoscopic intervention was considered.
A lumen-apposing metal stent (LAMS) was used to address the anatomical and functional abnormalities causing Roux stasis syndrome. A 20-mm LAMS was used to improve flow by creating communication between the two segments ([Fig. 1] b, [Video 1]), resulting in immediate symptomatic relief. The stent will be removed in three months with simultaneous resection of the residual mucosal spur ([Fig. 1] c).
Qualität:
LAMS provides an effective, minimally invasive approach to the treatment of Roux stasis syndrome, offering an alternative to surgery in selected cases. Future studies are needed to validate its long-term efficacy and role in broader management strategies for this syndrome.
Endoscopy_UCTN_Code_TTT_1AS_2AB
E-Videos is an open access online section of the journal Endoscopy, reporting on interesting cases and new techniques in gastroenterological endoscopy. All papers include a high-quality video and are published with a Creative Commons CC-BY license. Endoscopy E-Videos qualify for HINARI discounts and waivers and eligibility is automatically checked during the submission process. We grant 100% waivers to articles whose corresponding authors are based in Group A countries and 50% waivers to those who are based in Group B countries as classified by Research4Life (see: https://www.research4life.org/access/eligibility/).
This section has its own submission website at https://mc.manuscriptcentral.com/e-videos.
Publikationsverlauf
Artikel online veröffentlicht:
27. März 2025
© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).
Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
-
References
- 1 Wei M, Wang N, Yin Z. et al. Short-term and quality of life outcomes of patients using linear or circular stapling in esophagojejunostomy after laparoscopic total gastrectomy. J Gastrointest Surg 2021; 25: 1667-1676
- 2 Lu J, Wu Z, Liu G. et al. The clinical effectiveness of establishing a proximal jejunum pouch after laparoscopic total gastrectomy: A propensity score-based analysis. Asian J Surg 2022; 45: 425-430
- 3 Gustavsson S, Ilstrup DM, Morrison P. et al. Roux-Y stasis syndrome after gastrectomy. Am J Surg 1988; 155: 490-494