Endoscopic treatment of esophagogastric and esophagojejunal anastomotic leaks: A single tertiary center experience

Medicine · 3 authors, 2 centres

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TL;DR

The study found a high overall clinical success rate of 87.5%, with a 100% technical success rate for stent placement.

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This retrospective case series from a single tertiary center in Turkey analyzed 24 patients who developed postoperative anastomotic leaks after cancer surgery (esophageal or gastric) and were treated with endoscopic FCSEMS placement between 2015 and 2021. The clinical success rate was notably higher for esophagojejunal anastomosis (94.7%) than for esophagogastric anastomosis (60%). Stent-related complications occurred in 50% of patients, with stent migration being the most common (37.5%). Three patients (12.5%) died from complications of the leak, including pulmonary infection and mediastinitis. The study concludes that endoscopic FCSEMS placement is a safe and technically successful procedure for managing these leaks, though clinical success varies by anastomosis type.

STUDY TYPE

case_report

SPECIALTY

gastroenterology

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AI pipeline

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100% · A

ORIGINAL PAPER

PMC10578745

Endoscopic treatment of esophagogastric and esophagojejunal anastomotic leaks: A single tertiary center experience

Medicine

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ABSTRACT

Abstract Anastomotic leakage in esophagogastric and esophagojejunal anastomoses after esophagectomy/gastrectomy is a severe complication with a high mortality rate. We aimed to evaluate the technical and clinical success and outcomes of endoscopic placement of fully covered self-expanding metallic stents (FCSEMSs) for treating anastomotic leaks that develop after cancer surgery. All consecutive patients treated at the Gastroenterology Department, Ankara City Hospital, Ankara, Turkey, who underwent endoscopic FCSEMSs for leaks of esophagogastric or esophagojejunal anastomosis between February 2015 and December 2021 were included in the study. We analyzed the data on leak characteristics, technical success, clinical success, stent-related complications, and mortality to investigate the clinical efficacy and safety of endoscopically implanted FCSEMSs. A total of 24 patients, 12 of whom were male were included in the study. The median age of the patients was 60 years (min-max: 38–84). Nineteen patients underwent esophagojejunal anastomosis, and 5 patients underwent esophagogastric anastomosis. The median stent follow-up time was 68.8 (26–190) days, and the median hospital stay was 62.7 (24–145) days. Complications related to stent placement were observed in of 50%. The most common complication was stent migration, occurring at a frequency of 37.5%. The median follow-up period time was 11.4 (2–37) months. While the clinical success rate was 87.5%, 3 patients died. Endoscopic placement of FCSEMSs is a relatively safe and beneficial treatment for esophagojejunal and esophagogastric anastomotic leaks. Keywords: anastomotic leak, cancer surgery, endoscopic treatment, fully covered self-expanding metallic stents

CITATION EXPORT

Mustafa Cengiz, Bulent Odemis, Muhammed Bahattin Durak. Endoscopic treatment of esophagogastric and esophagojejunal anastomotic leaks: A single tertiary center experience. Medicine. (2023). https://doi.org/10.1097/MD.0000000000035582

AUTHORS

3 · 2 CENTRES

Mustafa Cengiz, Bulent Odemis, Muhammed Bahattin Durak

a Gulhane Research and Training Hospital, Department of Gastroenterology, Etlik, Ankara, Turkey
b Ankara City Hospital, Department of Gastroenterology, Ankara, Turkey.