Advertisement

Surgical Endoscopy

, Volume 27, Issue 11, pp 4383–4384 | Cite as

Anastomotic dehiscence after esophagogastrectomy treated with stent and tissue matrix graft

  • Johan C. Bakken
  • Ryan LawEmail author
  • Dennis Wigle
  • Todd H. Baron
Video
  • 176 Downloads

Dehiscence of the esophagogastric anastomosis remains a rare but feared complication following esophagectomy for esophageal cancer. Postoperative anastomotic leaks occur in 3–18 % of patients who undergo esophagectomy [1, 2, 3, 4], with complete or near-complete anastomotic dehiscence occurring in 1 % [5]. Here we report a unique case of successful closure of a near-complete anastomotic dehiscence following an Ivor–Lewis esophagectomy utilizing a combination of endoscopic and surgical techniques.

Case report

The patient was a 68-year-old man who presented with solid-food dysphagia and was subsequently diagnosed with esophageal adenocarcinoma. Cancer staging using combined PET/CT imaging and EUS revealed a T2N0 distal esophageal lesion and an additional FDG-avid lesion in the left lung, initially thought to be metastatic disease. CT-guided biopsy was performed and histology demonstrated a synchronous non-small-cell lung cancer in his left lung. Attention was focused initially on his...

Keywords

Esophageal Cancer Anastomotic Leak Esophagogastric Anastomosis Abdominal Wall Reconstruction Postoperative Anastomotic Leak 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Disclosures

Todd H. Baron received research support from Cook Endoscopy, Winston-Salem, NC. Johan C. Bakken, Ryan Law, and Dennis Wigle have no conflicts of interest or financial ties to disclose.

Supplementary material

Supplementary material 1 (MP4 77,411 kb)

References

  1. 1.
    Lorentz T, Fok M, Wong J (1989) Anastomotic leakage after resection and bypass for esophageal cancer: lessons learned from the past. World J Surg 13:472–477. doi: 10.1007/BF01660760 PubMedCrossRefGoogle Scholar
  2. 2.
    Whooley BP, Law S, Alexandrou A, Murthy SC, Wong J (2001) Critical appraisal of the significance of intrathoracic anastomotic leakage after esophagectomy for cancer. Am J Surg 181:198–203PubMedCrossRefGoogle Scholar
  3. 3.
    Schweigert M, Solymosi N, Dubecz A, Stadlhuber RJ, Muschweck H, Ofner D, Stein HJ (2013) Endoscopic stent insertion for anastomotic leakage following oesophagectomy. Ann R Coll Surg Engl 95:43–47PubMedCrossRefGoogle Scholar
  4. 4.
    Tapias LF, Muniappan A, Wright CD, Gaissert HA, Wain JC, Morse CR, Donahue DM, Mathisen DJ, Lanuti M (2013) Short- and long-term outcomes after esophagectomy for cancer in elderly patients. Ann Thorac Surg 95:1741–1748PubMedCrossRefGoogle Scholar
  5. 5.
    Griffin SM, Shaw IH, Dresner SM (2002) Early complications after Ivor–Lewis subtotal esophagectomy with two-field lymphadenectomy: risk factors and management. J Am Coll Surg 194:285–297PubMedCrossRefGoogle Scholar
  6. 6.
    Turkyilmaz A, Eroglu A, Aydin Y, Tekinbas C, Muharrem Erol M, Karaoglanoglu N (2009) The management of esophagogastric anastomotic leak after esophagectomy for esophageal carcinoma. Dis Esophagus 22:119–126PubMedCrossRefGoogle Scholar
  7. 7.
    Matory YL, Burt M (1993) Esophagogastrectomy: reoperation for complications. J Surg Oncol 54:29–33PubMedCrossRefGoogle Scholar
  8. 8.
    Bakken JC, Wong Kee Song LM, de Groen PC, Baron TH (2010) Use of a fully covered self-expandable metal stent for the treatment of benign esophageal diseases. Gastrointest Endosc 72:712–720PubMedCrossRefGoogle Scholar
  9. 9.
    Papachristou GI, Baron TH (2007) Use of stents in benign and malignant esophageal disease. Rev Gastroenterol Disord 7:74–88PubMedGoogle Scholar
  10. 10.
    Jansen LA, De Caigny P, Guay NA, Lineaweaver WC, Shokrollahi K (2013) The evidence base for the acellular dermal matrix AlloDerm: a systematic review. Ann Plast Surg 70:587–594PubMedCrossRefGoogle Scholar
  11. 11.
    Bozuk MI, Fearing NM, Leggett PL (2006) Use of decellularized human skin to repair esophageal anastomotic leak in humans. JSLS 10:83–85PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Johan C. Bakken
    • 1
  • Ryan Law
    • 1
    Email author
  • Dennis Wigle
    • 2
  • Todd H. Baron
    • 1
  1. 1.Division of Gastroenterology and HepatologyMayo ClinicRochesterUSA
  2. 2.Division of General Thoracic SurgeryMayo ClinicRochesterUSA

Personalised recommendations