Sequential endoscopic drainage and clip closure of an intrathoracic esophagogastric anastomotic dehiscence

Costa, Samuel; Ferreira, Carlos Noronha; Esteves, Rui; Lages, Patrícia; Costa, Paulo; Ribeiro, Luís; Velosa, José

doi:10.1055/s-0034-1377352

Cited by 2 publications

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“…[32][33][34] The median survival was significantly reduced in patients treated with stents (SG) compared with the group of patients treated without stents (NSG). The recurrence-free period was likewise reduced, but even though there was a significant difference in the KaplanMeier plots for the SG compared to NSG, the adjusted hazard ratio of 1.46 was not statistical significant different (P 5 0.076).…”

Section: Discussionmentioning

confidence: 99%

A bridging stent to surgery in patients with esophageal and gastroesophageal junction cancer has a dramatic negative impact on patient survival

Kjær

Nassar

Jensen

et al. 2016

Diseases of the Esophagus

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This study aimed to assess the impact of esophageal stenting on postoperative complications and survival in patients with obstructing esophageal and gastroesophageal junction (GEJ) cancer. All patients treated without neoadjuvant therapy that had an R0-resection performed for esophageal and GEJ cancer between January 2003 and December 2010 were identified from a prospectively maintained database. Data on stenting, postoperative mortality, morbidity, recurrence-free survival, complications, and length of hospital stay were collected. Kaplan-Meier plots for survival and recurrence-free survival curves were constructed for R0 resected patients. Data were compared between the stent and no-stent group by nonparametric tests. Two hundred seventy three consecutive R0 resected patients with esophageal or GEJ cancer were identified. Of these patients, 63 had a stent as a bridge to surgery. The male/female ratio was 2.64 (198/75) with a median age in the stent group (SG) of 65.1 versus 64.3 in the no stent group (NSG). Patients were comparable with respect to gender, age, smoking, TNM-classification, oncological treatment, hospital stay, tumor location, and histology. The median survival in the SG was 11.6 months compared with 21.3 months for patients treated without a bridging stent (P < 0.001). There were no statistically significant differences in 30-day mortality between the two groups, but NSG patients exhibited a significantly better two-year survival (P = 0.017). The median recurrence-free survival was 9.1 months for the SG compared with 15.2 months for the NSG. The use of a stent as a bridging procedure to surgery in patients treated without neaoadjuvant therapy for an esophageal or GEJ cancer that later underwent R0 resection decreased the two year survival and the recurrence-free survival.

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Section: Discussionmentioning

confidence: 99%

A bridging stent to surgery in patients with esophageal and gastroesophageal junction cancer has a dramatic negative impact on patient survival

Kjær

Nassar

Jensen

et al. 2016

Diseases of the Esophagus

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“…Although surgical management is considered the primary treatment, it is often difficult to perform given the potential morbidity risks associated with reoperation. As alternatives, many patients have been treated with various endoscopic techniques [ 5 – 7 ]. However, no uniform endoscopic method exists for correcting postoperative anastomotic leakage.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Vacuum-Assisted Closure Therapy in Patients with Anastomotic Leakage after Esophagectomy: A Single-Center Experience

Noh

Ahn

Lee

et al. 2018

Gastroenterology Research and Practice

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Aim To study the efficacy of E-VAC therapy for patients with anastomotic leakage after esophagectomy. Methods Between January 2013 and April 2017, 12 patients underwent E-VAC therapy for the management of postoperative leakage. Their clinical features and endoscopic procedure details, therapy results, adverse events, and survival were investigated. Results All 12 patients were male and the median age was 57 years (interquartile range 51.5–62.8 years). The reasons for esophageal surgery were esophageal cancer (83.3%), gastrointestinal stromal tumor (8.3%), and esophageal diverticulum (8.3%). Prior to E-VAC therapy, 6 patients had undergone failed primary surgical repair and the median duration from esophagectomy to leakage discovery was 13.5 days (IQR 6–207 days). The median duration of E-VAC therapy was 25 days (IQR 13.5–34.8 days) and the average sponge exchange rate was 2.7 times during the treatment period. After E-VAC therapy, 8 patients (66.7%) had complete leakage closure, 3 (25%) had a decreased leakage size, and 1 (8.3%) was unchanged. The three patients with a decreased leakage size after E-VAC therapy were treated with endoscopic and conservative management without further surgery. Conclusion With proper patient selection, E-VAC therapy is a feasible and safe method for the treatment of anastomotic leakage after esophagectomy.

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Sequential endoscopic drainage and clip closure of an intrathoracic esophagogastric anastomotic dehiscence

Cited by 2 publications

References 0 publications

A bridging stent to surgery in patients with esophageal and gastroesophageal junction cancer has a dramatic negative impact on patient survival

A bridging stent to surgery in patients with esophageal and gastroesophageal junction cancer has a dramatic negative impact on patient survival

Endoscopic Vacuum-Assisted Closure Therapy in Patients with Anastomotic Leakage after Esophagectomy: A Single-Center Experience

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