Journal of Gastrointestinal Surgery

, Volume 12, Issue 7, pp 1168–1176 | Cite as

Treatment of Thoracic Esophageal Anastomotic Leaks and Esophageal Perforations with Endoluminal Stents: Efficacy and Current Limitations

  • Dirk Tuebergen
  • Emile Rijcken
  • Rudolf Mennigen
  • Ann M. Hopkins
  • Norbert Senninger
  • Matthias Bruewer
original article

Abstract

Background

Intra-thoracic esophageal leakage after esophageal resection or esophageal perforation is a life-threatening event. The objective of this non-randomized observational study was to evaluate the effects of endoluminal stent treatment in patients with esophageal anastomotic leakages or perforations in a single tertiary care center.

Methods

Thirty-two consecutive patients with an intrathoracic esophageal leak, caused by esophagectomy (n = 19), transhiatal gastrectomy (n = 3), laparoscopic fundoplication (n = 2), and iatrogenic or spontaneous perforation (n = 8), undergoing endoscopic stent treatment were evaluated. Hospital stay, mortality and morbidity, sealing rate, extraction rates, complications, and long-term effects were measured.

Results

Median time interval between diagnosis and stent treatment was 3 and 5 days, respectively. Eighteen patients had futile surgical closure of the defect before stenting, while in 14 patients, stent placement was the primary treatment for leakage. Stent placement was technically correct in all patients. Functional sealing was achieved in 78%. Mortality was 15.6%. Stent extraction rate was 70%. Overall method-related complications occurred in nine patients (28%).

Conclusions

Implantation of self-expanding stents after esophageal resection or perforation is a feasible and safe procedure with an acceptable morbidity even if used as last-choice treatment.

Keywords

Esophageal leak Esophageal perforation Endoluminal stent Endoscopy Esophageal surgery 

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Copyright information

© The Society for Surgery of the Alimentary Tract 2008

Authors and Affiliations

  • Dirk Tuebergen
    • 2
  • Emile Rijcken
    • 1
  • Rudolf Mennigen
    • 1
  • Ann M. Hopkins
    • 3
  • Norbert Senninger
    • 1
  • Matthias Bruewer
    • 1
  1. 1.Department of General SurgeryUniversity of MuensterMuensterGermany
  2. 2.Department of General Surgery, Unit of Surgical EndoscopyUniversity of MuensterMuensterGermany
  3. 3.Department of SurgeryRoyal College of Surgeons in IrelandDublinIreland

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