Z Gastroenterol 2018; 56(11): 1365-1368
DOI: 10.1055/a-0710-5419
Kasuistik
© Georg Thieme Verlag KG Stuttgart · New York

Endoscopic suturing as a less invasive approach for the treatment of anastomotic leakage after esophagogastrostomy – a case report

Fallbericht: Endoskopische Vollwandnaht bei Anastomoseninsuffizienz nach Ösophagogastrostomie
Tobias Schlosser
1   Department of Internal Medicine, Neurology, and Dermatology, Division of Gastroenterology and Rheumatology
,
Juergen Feisthammel
2   University of Leipzig, Germany
,
Ines Gockel
3   Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Medical Center of Leipzig, Germany
,
Joachim Mössner
4   Division of Gastroenterology and Rheumatology, University Hospital Leipzig, Germany
,
Albrecht Hoffmeister
5   Medizinische Klinik 2, Universitätsklinikum Leipzig, Germany
› Author Affiliations
Further Information

Publication History

15 December 2017

16 August 2018

Publication Date:
12 November 2018 (online)

Abstract

Anastomotic leakage is a frequent complication after gastrointestinal (GI) surgery and is associated with high morbidity and mortality. Endoluminal therapy offers numerous advantages compared to surgical revision. We present the case of a 74-year-old female patient with anastomotic leakage after esophagogastrostomy. The defect was closed using the OverStitch endoscopic suturing system with immediate technical and clinical success. Hereby, an example of the feasibility of this novel technique in a case of anastomotic leakage is presented and provides an outlook for the rising importance of endoscopic therapy.

Zusammenfassung

Anastomoseninsuffizenzen sind eine häufige Komplikation nach gastrointestinalen Operationen und mit einer hohen Mortalität assoziiert. Im Vergleich zur chirurgischen Revision bietet die endoskopische Therapie verschiedene Vorteile. Hier soll der Fall einer 74-jährigen Patientin mit einer Anastomoseninsuffizienz nach Ösophagogastrostomie dargestellt werden. Mittels OverStitch™-Nahtsystem gelang der endoskopische Verschluss mit sofortigem technischem und klinischem Erfolg. In diesem Fall zeigt sich das Potenzial dieses endoluminalen Nahtverfahrens bei Anastomoseninsuffizienzen als eines von vielen Anwendungsgebieten der interventionellen Endoskopie.

 
  • References

  • 1 Swain CP, Mills TN. An endoscopic sewing machine. Gastrointest Endosc 1986; 32: 36-38
  • 2 Filipi CJ, Lehman GA, Rothstein RI. et al. Transoral, flexible endoscopic suturing for treatment of GERD: a multicenter trial. Gastrointest Endosc 2001; 53: 416-422
  • 3 Stavropoulos SN, Modayil R, Friedel D. Current applications of endoscopic suturing. World J Gastrointest Endosc 2015; 7: 777-789
  • 4 Lee Y, Fujita H, Yamana H. et al. Factors affecting leakage following esophageal anastomosis. Surg Today 1994; 24: 24-29
  • 5 Lang H, Piso P, Stukenborg C. et al. Management and results of proximal anastomotic leaks in a series of 1114 total gastrectomies for gastric carcinoma. Eur J Surg Oncol 2000; 26: 168-171
  • 6 Kumar N, Thompson CC. Endoscopic management of complications after gastrointestinal weight loss surgery. Clin Gastroenterol Hepatol 2013; 11: 343-353
  • 7 Talbot M, Yee G, Saxena P. Endoscopic modalities for upper gastrointestinal leaks, fistulae and perforations. ANZ J Surg 2015; 87: 171-176
  • 8 Kumta NA, Boumitri C, Kahaleh M. New devices and techniques for handling adverse events: claw, suture, or cover?. Gastrointest Endosc Clin N Am 2015; 25: 159-168
  • 9 Fernandez-Esparrach G, Lautz DB, Thompson CC. Endoscopic repair of gastrogastric fistula after Roux-en-Y gastric bypass: a less-invasive approach. Surg Obes Relat Dis 2010; 6: 282-288
  • 10 Sharaiha RZ, Kumta NA, DeFilippis EM. et al. A Large multicenter experience with endoscopic suturing for management of gastrointestinal defects and stent anchorage in 122 patients: a retrospective review. J Clin Gastroenterol 2016; 50: 388-392
  • 11 Watson RR, Jirapinyo P, Thompson CC. Endoscopic repair of post-operative gastrointestinal fistulae using a novel endoscopic suturing device: technical feasibility and safety. Gastroenterology 2011; 140: S-118
  • 12 Kantsevoy SV, Bitner M, Mitrakov AA. et al. Response. Gastrointest Endosc 2014; 80: 363-364