Double layer stent for the treatment of leaks and fistula after upper gastrointestinal oncologic surgery: a retrospective study

Mandarino, Francesco Vito; Esposito, Dario; Spelta, G; Cavestro, Giulia Martina; Rosati, Riccardo; Gemma, Marco; Fanti, Lorella

doi:10.1007/s13304-021-01155-8

Cited by 12 publications

(7 citation statements)

References 29 publications

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“…The ESCC microbiota also exhibited altered nitrate and nitrite reductase activities. Comparable distinctions were detected when comparing esophageal microbiota of ESCC tissue to esophagitis and healthy controls [115] . ESCC patients displayed lower Faecalibacterium , Bacteroides , and Blautia but higher levels of Streptococcus .…”

Section: Malignant Esophageal Diseasementioning

confidence: 94%

“…Advancements in surgical techniques have certainly improved patient outcomes, but the incidence of post-esophagectomy leaks remains high, ranging between 11.4% and 21.2% [110] , [111] . Treatment strategies vary depending on the patient’s clinical status and time of presentation and may involve endoscopy, such as Endoscopic Vacuum Therapy (EVT) or esophageal stent placement [112] , [113] , [114] , [115] , [116] , [117] , [118] , or surgical reintervention. The high prevalence of anastomotic leaks highlights the need for a better understanding of the factors contributing to these complications and potential strategies for prevention and management.…”

Section: Post-surgical Complicationsmentioning

confidence: 99%

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Microbiota profiling in esophageal diseases: Novel insights into molecular staining and clinical outcomes

Barchi,

Massimino,

Mandarino

et al. 2024

Computational and Structural Biotechnology Journal

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Section: Malignant Esophageal Diseasementioning

confidence: 94%

Section: Post-surgical Complicationsmentioning

confidence: 99%

Microbiota profiling in esophageal diseases: Novel insights into molecular staining and clinical outcomes

Barchi,

Massimino,

Mandarino

et al. 2024

Computational and Structural Biotechnology Journal

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“…Self-Expandable Metal Stents (SEMS) have represented the mainstay endoscopic technique for many years, promoting healing primarily due to mechanical bypass of the wall defect ( Supplementary Figure S1 ) [ 11 ]. Nevertheless, the use of SEMS is characterized by several complications, especially migration, which can occur in up to 23% of cases [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Vacuum Therapy (EVT) versus Self-Expandable Metal Stent (SEMS) for Anastomotic Leaks after Upper Gastrointestinal Surgery: Systematic Review and Meta-Analysis

Mandarino

Barchi

D’Amico

et al. 2023

Life

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Background: Endoscopic treatment of post-esophagectomy/gastrectomy anastomotic dehiscence includes Self-Expandable Metal Stents (SEMS), which have represented the “gold standard” for many years, and Endoscopic Vacuum Therapy (EVT), which was recently introduced, showing promising results. The aim of the study was to compare outcomes of SEMS and EVT in the treatment of post-esophagectomy/gastrectomy anastomotic leaks, focusing on oncologic surgery. Methods: A systematic search was performed on Pubmed and Embase, identifying studies comparing EVT versus SEMS for the treatment of leaks after upper gastro-intestinal surgery for malignant or benign pathologies. The primary outcome was the rate of successful leak closure. A meta-analysis was conducted, performing an a priori-defined subgroup analysis for the oncologic surgery group. Results: Eight retrospective studies with 357 patients were eligible. Overall, the EVT group showed a higher success rate (odd ratio [OR] 2.58, 95% CI 1.43–4.66), a lower number of devices (pooled mean difference [pmd] 4.90, 95% CI 3.08–6.71), shorter treatment duration (pmd −9.18, 95% CI −17.05- −1.32), lower short-term complication (OR 0.35, 95% CI 0.18–0.71) and mortality rates (OR 0.47, 95% CI 0.24–0.92) compared to stenting. In the oncologic surgery subgroup analysis, no differences in the success rate were found (OR 1.59, 95% CI 0.74–3.40, I2 = 0%). Conclusions: Overall, EVT has been revealed to be more effective and less burdened by complications compared to stenting. In the oncologic surgery subgroup analysis, efficacy rates were similar between the two groups. Further prospective data need to define a unique management algorithm for anastomotic leaks.

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“…Surgical interventions might be required when sepsis, a secondary fistula, and other refractory conditions occur [ 10 , 11 , 12 , 13 ]. However, several methods of endoscopic intervention have been reported, including tissue sealing using fibrin glue or cyanoacrylate [ 14 , 15 , 16 ], metal stents [ 17 , 18 , 19 , 20 , 21 , 22 ], endoscopic vacuum therapy [ 23 , 24 , 25 ], and suturing devices [ 26 , 27 ]. However, these techniques are often challenging because of a lack of certainty and evidence.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Endoscopic Intervention Using Over-the-Scope Clips for Anastomotic Leakage Involving Secondary Fistula after Gastrointestinal Surgery: A Japanese Multicenter Case Series

Tada,

Kobara,

Tashima

et al. 2023

Diagnostics

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Background: The over-the-scope clip (OTSC) is a highly effective clipping device for refractory gastrointestinal disease. However, Japanese data from multicenter studies for anastomotic leakage (AL) involving a secondary fistula after gastrointestinal surgery are lacking. Therefore, this study evaluated the efficacy and safety of OTSC placement in Japanese patients with such conditions. Methods: We retrospectively collected data from 28 consecutive patients from five institutions who underwent OTSC-mediated closure for AL between July 2017 and July 2020. Results: The AL and fistula were located in the esophagus (3.6%, n = 1), stomach (10.7%, n = 3), small intestine (7.1%, n = 2), colon (25.0%, n = 7), and rectum (53.6%, n = 15). The technical success, clinical success, and complication rates were 92.9% (26/28), 71.4% (20/28), and 0% (0/28), respectively. An age of <65 years (85.7%), small intestinal AL (100%) and colonic AL (100%), defect size of <10 mm (82.4%), time to OTSC placement > 7 days (84.2%), and the use of simple suction (78.9%) and anchor forceps (80.0%) were associated with higher clinical success rates. Conclusion: OTSC placement is a useful therapeutic option for AL after gastrointestinal surgery.

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Double layer stent for the treatment of leaks and fistula after upper gastrointestinal oncologic surgery: a retrospective study

Cited by 12 publications

References 29 publications

Microbiota profiling in esophageal diseases: Novel insights into molecular staining and clinical outcomes

Microbiota profiling in esophageal diseases: Novel insights into molecular staining and clinical outcomes

Endoscopic Vacuum Therapy (EVT) versus Self-Expandable Metal Stent (SEMS) for Anastomotic Leaks after Upper Gastrointestinal Surgery: Systematic Review and Meta-Analysis

Outcomes of Endoscopic Intervention Using Over-the-Scope Clips for Anastomotic Leakage Involving Secondary Fistula after Gastrointestinal Surgery: A Japanese Multicenter Case Series

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