OBJECTIVE: 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 esophago-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.
OBJECTIVE: 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 esophago-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.
Authors: Gennaro Galizia; Vincenzo Napolitano; Paolo Castellano; Margherita Pinto; Anna Zamboli; Pietro Schettino; Michele Orditura; Ferdinando De Vita; Annamaria Auricchio; Andrea Mabilia; Angelo Pezzullo; Eva Lieto Journal: J Gastrointest Surg Date: 2012-03-07 Impact factor: 3.452
Authors: Sivesh K Kamarajah; James Bundred; Gary Spence; Andrew Kennedy; Bobby V M Dasari; Ewen A Griffiths Journal: World J Surg Date: 2020-04 Impact factor: 3.352
Authors: Tomasz Miłek; Piotr Ciostek; Robert Petryka; Jakub Słowik; Mirosław Jarosz Journal: Wideochir Inne Tech Maloinwazyjne Date: 2015-12-15 Impact factor: 1.195