Universität zu Köln

Plum, Patrick Sven, Herbold, Till, Berlth, Felix, Christ, Hildegard ORCID: 0000-0003-3235-2994, Alakus, Hakan, Bludau, Marc, Chang, De-Hua, Bruns, Christiane Josephine, Hoelscher, Arnulf Heinrich and Chon, Seung-Hun ORCID: 0000-0002-8923-6428 (2019). Outcome of Self-Expanding Metal Stents in the Treatment of Anastomotic Leaks After Ivor Lewis Esophagectomy. World J.Surg., 43 (3). S. 862 - 870. NEW YORK: SPRINGER. ISSN 1432-2323

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Abstract

BackgroundEsophageal anastomotic leakages after Ivor Lewis esophagectomy are severe and life-threatening complications. We analyzed the outcome of using self-expanding metal stents (SEMS) in the treatment of postoperative leakage afteresophagogastrostomy.MethodsSeventy patients with esophageal anastomotic leakage after Ivor Lewis esophagectomy for esophageal cancer who had received SEMS treatment between January 2006 and December 2015 at our clinic were identified in this retrospective study. The patients were analyzed according to demographic characteristics, risk factors, leakage characteristics, stent characteristics, stent-related complications, sealing success rate and mortality.ResultsOver a 10-year period, 70 patients received SEMS as treatment for postoperative anastomotic leakage after esophagectomy. Technical success of esophageal stenting in anastomotic leakage was achieved in 50 out of 70 cases (71.4%). Sealing success rate was 70% (n=49) with a median treatment of 28days (range 7-87). In 20 patients (28.6%), stent-related complications, such as stenosis, dislocation, leakage persistence, perforation or esophagotracheal fistula occurred after the SEMS treatment. Sixty-one patients (87.1%) survived SEMS treatment of esophagogastric anastomotic leakage. Mean follow-up for all patients was 38months (IQR 10-76), and no significant difference was found in a comparison of the long-term survival rate between patients with successful and unsuccessful SEMS treatment.ConclusionsThe management of esophageal anastomotic leaks after Ivor Lewis esophagectomy with SEMS is effective, safe and technically feasible. Aggressive non-surgical management should be considered when developing a treatment plan for stenting.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Plum, Patrick Sven UNSPECIFIED UNSPECIFIED UNSPECIFIED Herbold, Till UNSPECIFIED UNSPECIFIED UNSPECIFIED Berlth, Felix UNSPECIFIED UNSPECIFIED UNSPECIFIED Christ, Hildegard UNSPECIFIED orcid.org/0000-0003-3235-2994 UNSPECIFIED Alakus, Hakan UNSPECIFIED UNSPECIFIED UNSPECIFIED Bludau, Marc UNSPECIFIED UNSPECIFIED UNSPECIFIED Chang, De-Hua 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:38-156154
DOI:	10.1007/s00268-018-4832-2
Journal or Publication Title:	World J.Surg.
Volume:	43
Number:	3
Page Range:	S. 862 - 870
Date:	2019
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1432-2323
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ROUTINE CONTRAST ESOPHAGRAM; VACUUM-ASSISTED CLOSURE; MANAGEMENT; ESOPHAGOGASTRECTOMY; COMPLICATIONS; EFFICACY; SURGERY; IMPACT Multiple languages Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/15615