Endoscopy cornerHealing Occurs in Most Patients That Receive Endoscopic Stents for Anastomotic Leakage; Dislocation Remains a Problem
Section snippets
Study Cohort
Between 2003 and 2009, there were 1296 patients who underwent esophagectomy or trans-hiatally extended gastrectomy for carcinomas of the esophagus or esophagogastric junction in the Department of Surgery at the Klinikum Rechts der Isar, Technische Universität München, as a national referral center for these tumor entities. In 115 patients (9%; 95% confidence interval [CI], 7.4%–10.5%), a fully covered self-expanding metal stent was placed endoscopically as the first treatment option for
Results
The median interval between surgery and diagnosis of anastomotic leakage with endoscopic stent placement was 8 days (range, 3–21 d).
Discussion
The concept of additional stent placement in the conservative management of esophageal anastomotic leakage after esophagectomy or gastrectomy provides the advantage of immediate leak occlusion, which allows early oral feeding, avoids further contamination of the mediastinum, and, finally, results in shorter hospital stays.12, 13, 14, 15, 16, 17, 18, 19 However, stent placement also forces the need for adequate perianastomotic drainage because stents not only stop further intestinal leakage to
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Conflicts of interest The authors disclose no conflicts.