Endoscopy 2021; 53(S 01): S43
DOI: 10.1055/s-0041-1724361
Abstracts | ESGE Days
ESGE Days 2021 Oral presentations
Friday, 26 March 2021 11:00 – 11:45 Endoscopic management of leaks and fistula Room 5

Endoscopic Management of Anastomotic Leaks Following Esophagectomy for Esophageal Cancer

R Ortigão
1   Oncology Institute of Porto, Gastrenterology Department, Porto, Portugal
,
B Pereira
2   Oncology Institute of Porto, Intensive Care Unit, Porto, Portugal
,
R Silva
1   Oncology Institute of Porto, Gastrenterology Department, Porto, Portugal
,
P Bastos
1   Oncology Institute of Porto, Gastrenterology Department, Porto, Portugal
,
P Pimentel-Nunes
1   Oncology Institute of Porto, Gastrenterology Department, Porto, Portugal
3   Faculty of Medicine, University of Porto, MEDCIDS, Porto, Portugal
,
F Faria
2   Oncology Institute of Porto, Intensive Care Unit, Porto, Portugal
,
M Dinis-Ribbeiro
1   Oncology Institute of Porto, Gastrenterology Department, Porto, Portugal
3   Faculty of Medicine, University of Porto, MEDCIDS, Porto, Portugal
,
D Libânio
1   Oncology Institute of Porto, Gastrenterology Department, Porto, Portugal
3   Faculty of Medicine, University of Porto, MEDCIDS, Porto, Portugal
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Aims Anastomotic dehiscence after esophagectomy is associated with high morbimortality and impaired quality of life. The aim of this study was to evaluate the endoscopic treatment for esophageal anastomotic leakage (EAL) following esophagectomy for cancer.

Methods We retrospectively analyzed consecutive patients who undergone endoscopic treatment for EAL after esophagectomy for esophageal and gastroesophageal junction cancer at a tertiary oncology hospital between 2014 and 2019.

Results Eleven patients underwent endoscopic treatment for EAL (10 as first approach, 1 after failure of surgical treatment). The extent of esophageal dehiscence was <25 % of the anastomotic circumference in 7 patients and between 25 and 50 % in 4 patients. Median time from esophagectomy to EAL diagnosis was 5 days. Considering patients with endoscopic treatment as first approach, self-expandable metal stents (SEMS) were used in 6 patients, through-the-scope endoclips (TTS) in 2 patients, over-the-scope clip in 1 patient and 1 patient received TTS endoclip and SEMS. Technical and clinical success occurred in 9/10. One patient needed post-endoscopy surgical intervention and died during hospitalization. Complications related to stent insertion occurred in 4 patients (57.1 %): 1 case of stent migration and 3 cases of esophageal stricture, all manageable with endoscopic treatments. Nine patients were discharged under oral intake (median time to oral intake of 10 days), after a median length of intensive care and general ward stay of 4 days (interquartile range 3-13.5) and 36 days (interquartile range 21-56.5), respectively. Endoscopic vacuum therapy was used in 1 patient after failure of surgical reintervention and endoscopic stent treatment. Thirteen sponges were used and the treatment lasted 31 days with leak healing. In-hospital mortality rate after endoscopic treatment was 9,1 %.

Conclusions Endoscopic treatment is a reliable and efficient approach to the management of EAL, providing timely oral nutrition and avoiding the morbimortality of surgical reintervention.

Citation: Ortigão R, Pereira B, Silva R et al. OP102 ENDOSCOPIC MANAGEMENT OF ANASTOMOTIC LEAKS FOLLOWING ESOPHAGECTOMY FOR ESOPHAGEAL CANCER. Endoscopy 2021; 53: S43.



Publication History

Article published online:
19 March 2021

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