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Treatment of oesophageal anastomotic leaks by temporary stenting with self-expanding plastic stents

Item Type:Article
Title:Treatment of oesophageal anastomotic leaks by temporary stenting with self-expanding plastic stents
Creators Name:Dai, Y.Y., Gretschel, S., Dudeck, O., Rau, B., Schlag, P.M. and Huenerbein, M.
Abstract:BACKGROUND:: Oesophageal anastomotic leakage is associated with considerable morbidity and mortality. The aim of the present study was to assess the feasibility of using temporary self-expanding plastic stents to treat postoperative oesophageal leaks. METHODS:: Patients with anastomotic leakage after abdominothoracic oesophagectomy treated by endoscopic insertion of self-expanding plastic stents between 2001 and 2007 were studied. Clinical outcomes were analysed, including healing of the leak, morbidity and mortality. RESULTS:: Stents were inserted successfully in all 22 patients without procedure-related complications. Ten patients also required computed tomography-guided drainage because surgical drains had been removed. Non-ventilated patients received oral nutrition a mean of 4 days after stent placement. Combined treatment with stenting and drainage resulted in resolution of the leak in 21 of 22 patients. The mean healing time (time to stent removal) was 23 days. Stent migration occurred in five of 22 patients, but endoscopic reintervention with placement of a new stent was successful in all patients. Repeat thoracotomy with intraoperative stent placement was necessary in one patient with an oesophagocolonic anastomosis. One patient died in hospital. CONCLUSION:: In combination with effective drainage, self-expanding plastic stents are an option for the treatment of oesophageal anastomotic leaks, and may reduce leak-related morbidity and mortality.
Keywords:Surgical Anastomosis, Esophageal Neoplasms, Esophagectomy, Feasibility Studies, Stents, Surgical Wound Dehiscence, Wound Healing
Source:British Journal of Surgery
Page Range:887-891
Date:August 2009
Official Publication:https://doi.org/10.1002/bjs.6648
PubMed:View item in PubMed

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