Endoscopy 2018; 50(04): S167
DOI: 10.1055/s-0038-1637542
ESGE Days 2018 ePosters
Georg Thieme Verlag KG Stuttgart · New York

MANAGEMENT OF ESOPHAGEAL ANASTOMOTIC LEAKS WITH SELF-EXPANDING METAL STENTS AFTER TOTAL ESOPHAGECTOMY OR GASTRECTOMY

V Anapaz
1   Hospital Prof. Doutor Fernando Fonseca, Gastroenterology, Lisbon, Portugal
,
D Aparício
2   Hospital Prof. Doutor Fernando Fonseca, Surgery, Lisbon, Portugal
,
R Carvalho
1   Hospital Prof. Doutor Fernando Fonseca, Gastroenterology, Lisbon, Portugal
,
A Oliveira
1   Hospital Prof. Doutor Fernando Fonseca, Gastroenterology, Lisbon, Portugal
,
L Lourenço
1   Hospital Prof. Doutor Fernando Fonseca, Gastroenterology, Lisbon, Portugal
,
L Santos
1   Hospital Prof. Doutor Fernando Fonseca, Gastroenterology, Lisbon, Portugal
,
D Horta
1   Hospital Prof. Doutor Fernando Fonseca, Gastroenterology, Lisbon, Portugal
,
N Pignatelli
2   Hospital Prof. Doutor Fernando Fonseca, Surgery, Lisbon, Portugal
,
A Gomes
2   Hospital Prof. Doutor Fernando Fonseca, Surgery, Lisbon, Portugal
,
V Nunes
2   Hospital Prof. Doutor Fernando Fonseca, Surgery, Lisbon, Portugal
,
J Reis
1   Hospital Prof. Doutor Fernando Fonseca, Gastroenterology, Lisbon, Portugal
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

Also available at
 

Aims:

Esophageal, gastric and esophageal-jejunal anastomotic leaks (EEAL) after oncologic curative surgery are associated with considerable morbidity and mortality. The aim of the present study was to report our experience and assess the efficacy of self-expanding metal stents in the treatment of EEAL.

Methods:

We performed a review of patients with stent placement for EEAL from January 2010 until November 2017 at our Hospital. Success was defined as endoscopic defect closure and resumption of oral intake. Failure was defined as no change in leak size and clinical signs of sepsis. We included patients with EEAL diagnosed imagiologically, endoscopically or intraoperative.

Results:

Nine patients (n = 9) patients underwent esophageal stent placement for EEAL. 66% (n = 6) are females and the median age was 67 years old. The median time between surgery and the procedure was 13,3 days. There weren't immediate complications after the procedure, and 7 patients attained immediate technical success. After the procedure, one patient showed persistence of the leak and was submitted to another upper endoscopy to replace the stent, and other patient needed a second stent.

One patient developed anastomotic stenosis after stent removal that was successfully treated with endoscopic

dilatation.

We observed serious complications in two patients (22%): one patient had anastomotic hemorrhage tree days after the procedure and developed multiorgan failure (MOF) and another patient without evidence of persistent leak, also evolved unfavorably with MOF and died.

The mean time to remove the stent was 32,5 days.

Conclusions:

Our results suggest that early stenting is an option to be considered, taking into account the clinical status of the

patient, in cases of surgical complications after oncologic curative surgery. To access the real effectiveness and safety of this approach, other studies must be done with a larger number of patients enrolled.