ESOPHAGEAL STENT PLACEMENT FOR THE TREATMENT OF ANASTOMOTIC LEAK

Aims Evaluate the efficacy and safety of esophageal stent placement for the treatment of post-surgical esophageal anastomotic leaks.

Methods Retrospective observational study of esophageal anastomotic leaks treated with stents in a tertiary hospital between January 2017 and July 2021. Clinical success was defined as closure of the anastomotic leak after removal of the esophageal stent.

Fig. 1

Results 26 patients were included. 17 patients had an esophago-gastric anastomosis and 15 an esophagojejunal anastomosis. The mean anastomotic leak size was 10.5 mm. In 57.7% of patients, a Wallflex stent was placed and in 42.3% a Hannarostent stent. The mean stent length was 124 mm and the mean diameter 20 mm. Placement was guided by scopy in 77% of cases and in 23% by direct endoscopic vision. The median time from surgery was 11 days. The median time from placement to removal of the prosthesis was 37 days. Clinical success was achieved in 14 of the 26 patients (53.8%), in 11 of them after placement of 1 stent and in 4 after 2 stents. In the subgroup of patients with a dehiscence<8 mm, the clinical success was 68.7%, while in the subgroup with>8 mm, was 30%. 11 patients had sepsis at the time of the procedure, of which 9 (81.8%) did not achieve clinical success. Technical success was 100%, with no immediate complications.

Table 1

Variables	OR	Lower 95%	Upper 95%	P-value
Leak size	1.4	1.07	2.4	0.04
Sepsis	15.2	1.9	154	0.02
Time from surgery	1.02	0.95	1.1	0.5

Conclusions Endoscopic stent placement appears to be an effective and safe treatment for esophageal anastomotic leaks. The larger size of the dehiscence and sepsis are factors that decrease the clinical success.

Publication History

Article published online:
14 April 2022