Universität zu Köln

Berlth, Felix, Bludau, Marc, Plum, Patrick Sven, Herbold, Till, Christ, Hildegard ORCID: 0000-0003-3235-2994, Alakus, Hakan, Kleinert, Robert, Bruns, Christiane Josephine, Hoelscher, Arnulf Heinrich and Chon, Seung-Hun ORCID: 0000-0002-8923-6428 (2019). Self-Expanding Metal Stents Versus Endoscopic Vacuum Therapy in Anastomotic Leak Treatment After Oncologic Gastroesophageal Surgery. J. Gastrointest. Surg., 23 (1). S. 67 - 76. NEW YORK: SPRINGER. ISSN 1873-4626

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Abstract

BackgroundAnastomotic leak after gastroesophageal surgery is a life-threatening complication. Self-expanding metal stent (SEMS) implantation or endoscopic vacuum therapy (EVT) have been established as alternatives to reoperation. This study compares the outcome of both interventions for anastomotic leak clinical management.MethodsIn this retrospective study, we identified all patients who received SEMS or EVT for anastomotic leaks after oncological gastroesophageal surgery between January 2007 and December 2016. Only patients with type II leaks according to the Esophagectomy Complications Consensus Group were included. Sealing rates, intervention-related complications, demographic characteristics, clinical history, leak characteristics, therapy duration, and in-hospital mortality were analyzed.ResultsOne hundred eleven patients who received SEMS (n=76) or EVT (n=35) were identified and categorized by primary and final treatment. The overall closure rate in the final treatment analysis was 85.7% for EVT and 72.4% for SEMS (p=0.152). ICU stay ranged from 0 to 60days (median 6days) for EVT and from 0 to 295days (median 9days) for SEMS (p=0.704). EVT patients were hospitalized for 19-119days (median 39days) and SEMS patients for 13-296days (median 37days; p=0.812). Demographic factors, comorbidities, and surgical parameters did not correlate with treatment or treatment success.ConclusionsSEMS and EVT show comparable results for anastomotic leak management after oncologic gastroesophageal surgery. No superior outcome could be found for either one of the two treatments options.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Berlth, Felix UNSPECIFIED UNSPECIFIED UNSPECIFIED Bludau, Marc UNSPECIFIED UNSPECIFIED UNSPECIFIED Plum, Patrick Sven UNSPECIFIED UNSPECIFIED UNSPECIFIED Herbold, Till UNSPECIFIED UNSPECIFIED UNSPECIFIED Christ, Hildegard UNSPECIFIED orcid.org/0000-0003-3235-2994 UNSPECIFIED Alakus, Hakan UNSPECIFIED UNSPECIFIED UNSPECIFIED Kleinert, Robert UNSPECIFIED UNSPECIFIED UNSPECIFIED Bruns, Christiane Josephine UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoelscher, Arnulf Heinrich UNSPECIFIED UNSPECIFIED UNSPECIFIED Chon, Seung-Hun UNSPECIFIED orcid.org/0000-0002-8923-6428 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-140151
DOI:	10.1007/s11605-018-4000-x
Journal or Publication Title:	J. Gastrointest. Surg.
Volume:	23
Number:	1
Page Range:	S. 67 - 76
Date:	2019
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1873-4626
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language LONG-TERM SURVIVAL; TRANSTHORACIC ESOPHAGECTOMY; ASSISTED CLOSURE; MANAGEMENT; DEVICE; IMPACT Multiple languages Gastroenterology & Hepatology; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/14015