Endoscopy 2018; 50(02): 148-153
DOI: 10.1055/s-0043-120442
Innovations and brief communications
© Georg Thieme Verlag KG Stuttgart · New York

Stent-over-sponge (SOS): a novel technique complementing endosponge therapy for foregut leaks and perforations

Piero V. Valli*
Division of Gastroenterology and Hepatology, University Hospital Zürich, Zürich, Switzerland
,
Joachim C. Mertens*
Division of Gastroenterology and Hepatology, University Hospital Zürich, Zürich, Switzerland
,
Arne Kröger
Division of Gastroenterology and Hepatology, University Hospital Zürich, Zürich, Switzerland
,
Christoph Gubler
Division of Gastroenterology and Hepatology, University Hospital Zürich, Zürich, Switzerland
,
Christian Gutschow
Department of Visceral and Transplant Surgery, University Hospital Zürich, Zürich, Switzerland
,
Paul M. Schneider
Department of Visceral and Transplant Surgery, University Hospital Zürich, Zürich, Switzerland
Center for Visceral-, Thoracic and specialized Tumor Surgery, Hirslanden Medical Center, Switzerland
,
Peter Bauerfeind
Division of Gastroenterology and Hepatology, University Hospital Zürich, Zürich, Switzerland
› Author Affiliations
Further Information

Publication History

submitted 16 May 2017

accepted after revision 21 August 2017

Publication Date:
27 October 2017 (eFirst)

Abstract

Background and study aims Endoluminal vacuum therapy (EVT) has evolved as a promising option for endoscopic treatment of foregut wall injuries in addition to the classic closure techniques using clips or stents. To improve vacuum force and maintain esophageal passage, we combined endosponge treatment with a partially covered self-expandable metal stent (stent-over-sponge; SOS).

Patients and methods Twelve patients with infected upper gastrointestinal wall defects were treated with the SOS technique.

Results Indications for SOS were anastomotic leakage after surgery (n = 11) and chronic foregut fistula (n = 1). SOS treatment was used as a first-line treatment in seven patients with a success rate of 71.4 % (5/7) and as a second-line treatment after failed previous EVT treatment in five patients (success rate 80 %; 4/5). Overall, SOS treatment was successful in 75 % of patients (9/12). No severe adverse events occurred.

Conclusion SOS is an effective method to treat severely infected foregut wall defects in patients where EVT has failed, and also as a first-line treatment. Comparative prospective studies are needed to confirm our preliminary results.

* Contributed equally to this work.