Sa1437 Esophageal Stenting With Sutures: Time to Redefine Our Standards?

Sharaiha, Reem Z.; Doukides, Theodore; Gonda, Tamas A.; Widmer, Jessica L.; Turner, Brian G.; Poneros, John M.; Gaidhane, Monica; Kahaleh, Michel; Sethi, Amrita

doi:10.1016/j.gie.2013.03.488

Cited by 12 publications

(20 citation statements)

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“…Stent migration was 11% in the group who received suturing versus 55% migration rate in the group who did not receive suturing (P = 0.04). 84 Be`ge and colleagues describes an entire endoscopic multimodal approach by transluminal debridement of necrotic tissue, use of endoscopic clips, injectable glue, and covered stents, as well as placement of a nasocystic catheter in 27 patients. The mean time until resolution was 86 days with an average of 4.4 endoscopies per patient.…”

Section: Staple-line Anastomotic Leaks and Fistulasmentioning

confidence: 99%

Endoscopic Management of Bariatric Surgery Complications

Cai

Schweitzer²,

Kumbhari³

2016

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Obesity is a global epidemic that has significant impact on morbidity, mortality, and rising health care costs. In morbidly obese patients with body mass index >40 kg/m2, bariatric surgery is a grade A recommendation and is associated with up to 40% reduction in premature death. Increasingly, endoscopy is seen as a safer and more cost-effective approach to the management of weight loss surgery complications including gastrointestinal bleeding, development of anastomotic ulcers, staple-line leaks and fistulas, strictures, weight regain, bezoars, choledocholithiasis, and gastric band erosion and slippage. Many endoscopic interventions currently rely on a combination of specialized equipment, such as stents, suture systems, clips, and balloon dilators to successfully treat these issues. This article will present common postoperative complications in bariatric surgery, discuss the latest evidence for their endoscopic management, and offer future directions in the endoluminal therapy of obese patients.

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Section: Staple-line Anastomotic Leaks and Fistulasmentioning

confidence: 99%

Endoscopic Management of Bariatric Surgery Complications

Cai

Schweitzer²,

Kumbhari³

2016

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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“…2). 69,70 Six to eight weeks is the optimal time to remove the stent. 2 A shorter interval can cause incomplete mucosal closure and longer interval can cause stent migration and tissue ingrowth.…”

Section: Endoluminal Stentsmentioning

confidence: 99%

“…Watson and Thompson 74 achieved durable closure of gastro-gastric fistula in 3 of their 7 patients using Overstitch device. Since the FDA approval in 2011, Overstitch has been successfully used in closure of iatrogenic esophageal perforations, 75 stent fixation, 69 endoscopic submucosal dissection (ESD) mucosal defect closure, 76 mucosal defect closure after Peroral Endoscopic Myotomy (POEM) 77 and stoma reduction post bariatric surgery.…”

Section: Endoscopic Suturing Devicementioning

confidence: 99%

Endoscopic management of postoperative fistulas and leaks

Devaraj

Gavini

2017

Int J Gastrointest Interv

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Postoperative complications from gastrointestinal surgery can be associated with significant morbidity, and mortality especially if repeat surgery is needed to address these complications. There are wide array of endoscopic interventions and tools available for management of these complications using minimally invasive methods thus decreasing length of hospitalization, morbidity and leading to better patient outcomes. With the advent new tools like Overstitch device, Over the Scope Clip, fibrin glue, etc., these complications can be managed successfully with minimal morbidity. We provide an indepth discussion about available endoscopic options and their application in various scenarios in our article. Endoscopist should be familiar with these complications and endoscopic tools to promote use of these tools and techniques to achieve successful management of these complex conditions.

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“…Another study retrospectively studied 37 patients who were divided into two groups; oesophageal stenting with suture placement (n=17; group A) and oesophageal stenting without suture placement (n=20; group B) 25. The study concluded that anchoring of the upper flare of the FCSEMS with endoscopic sutures is technically feasible and significantly reduces stent migration rate (35% in group A vs 55% in group B; p=0.04) and is a safe procedure with very low adverse event rates.…”

Section: Special Considerations For Stentingmentioning

confidence: 99%

Oesophageal stenting for benign and malignant strictures: a systematic approach

Rana

Dhar

2015

Frontline Gastroenterol

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Oesophageal stenting is now standard treatment for managing both benign and malignant stenosis of the oesophagus. There is a wide choice in oesophageal stents currently available on the market, with variations in the stent material, size and design. Most oesophageal stents are made from metal alloy compounds for use in malignant strictures, although there are stents made of durable polymers, and now of biodegradable (BD) material, for use in both benign and malignant strictures. With the development of self-expanding plastic stents, self-expanding metal stents and BD stents, stent placement for oesophageal pathologies can be safe and cost-effective. Oesophageal stenting has several challenges for a therapeutic endoscopist which is determined by the location of stricture or tumour, the anatomy of the stenosis and the nature of stent selected. Strictures that have narrow or tortuous lumens can be particularly difficult to stent as the luminal diameter must allow access of at least a 0.035 inch guide wire. This review covers the indications and outcomes of different stents in clinical situations to help rational decisionmaking.

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Sa1437 Esophageal Stenting With Sutures: Time to Redefine Our Standards?

Cited by 12 publications

References 0 publications

Endoscopic Management of Bariatric Surgery Complications

Endoscopic Management of Bariatric Surgery Complications

Endoscopic management of postoperative fistulas and leaks

Oesophageal stenting for benign and malignant strictures: a systematic approach

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