Document Detail


Treatment of oesophageal anastomotic leaks by temporary stenting with self-expanding plastic stents.
MedLine Citation:
PMID:  19591167     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Y Y Dai; S Gretschel; O Dudeck; B Rau; P M Schlag; M Hünerbein
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  The British journal of surgery     Volume:  96     ISSN:  1365-2168     ISO Abbreviation:  Br J Surg     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-15     Completed Date:  2009-08-27     Revised Date:  2010-01-26    
Medline Journal Info:
Nlm Unique ID:  0372553     Medline TA:  Br J Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  887-91     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Affiliation:
Department of Surgery and Surgical Oncology, Universitätsmedizin Berlin and Helios Hospital, Berlin, Buch and Charité Campus Buch, Germany.
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MeSH Terms
Descriptor/Qualifier:
Aged
Anastomosis, Surgical
Esophageal Neoplasms / surgery*
Esophagectomy / instrumentation*
Feasibility Studies
Female
Humans
Male
Middle Aged
Stents*
Surgical Wound Dehiscence / surgery*
Wound Healing / physiology
Comments/Corrections
Comment In:
Br J Surg. 2010 Feb;97(2):294; author reply 294-5   [PMID:  20069602 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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