Endoscopy 2010; 42(9): 757-759
DOI: 10.1055/s-0030-1255634
Case report/series

© Georg Thieme Verlag KG Stuttgart · New York

Endoscopic closure of postoperative esophageal leaks with a novel over-the-scope clip system

J.  Pohl1 , M.  Borgulya1 , D.  Lorenz2 , C.  Ell1
  • 1Department of Gastroenterology, Dr. Horst Schmitt Kliniken, Wiesbaden, Germany
  • 2Department of Surgery, Dr. Horst Schmitt Kliniken, Wiesbaden, Germany
Further Information

Publication History

submitted 23 February 2010

accepted after revision 1 June 2010

Publication Date:
30 August 2010 (online)

Management of esophageal anastomotic leaks is associated with high morbidity and mortality and remains an interdisciplinary challenge. We describe the first two cases of endoscopic closure of postoperative leaks following gastrectomy and primary repair after spontaneous acute esophageal perforation, using the over-the-scope clip (OTSC) system (Ovesco Endoscopy GmbH, Tübingen, Germany). Both leaks were successfully sealed with one clip. While one patient recovered without reintervention, in the other patient the postoperative leak reappeared following clip displacement 13 days later.

References

  • 1 Tabatabai A, Hashemi M, Mohajeri G. et al . Incidence and risk factors predisposing anastomotic leak after transhiatal esophagectomy.  Ann Thorac Med. 2009;  4 197-200
  • 2 Atkins B Z, Shah A S, Hutcheson K A. et al . Reducing hospital morbidity and mortality following esophagectomy.  Ann Thorac Surg. 2004;  78 1170-1176
  • 3 Schubert D, Scheidbach H, Kuhn R. et al . Endoscopic treatment of thoracic esophageal anastomotic leaks by using silicone-covered, self-expanding polyester stents.  Gastrointest Endosc. 2005;  61 891-896
  • 4 Dai Y Y, Gretschel S, Dudeck O. et al . Treatment of esophageal anastomotic leaks by temporary stenting with self-expanding plastic stents.  Br J Surg. 2009;  96 887-891
  • 5 Kauer W K, Stein H J, Dittler H J. et al . Stent implantation as a treatment option in patients with thoracic anastomotic leaks after esophagectomy.  Surg Endosc. 2008;  22 50-53
  • 6 Leers J M, Vivaldi C, Schäfer H. et al . Endoscopic therapy for esophageal perforation or anastomotic leak with a self-expandable metallic stent.  Surg Endosc. 2009;  23 2258-2262
  • 7 Rodella L, Laterza E, de Manzoni G. et al . Endoscopic clipping of anastomotic leakages in esophagogastric surgery.  Endoscopy. 1998;  30 453-456
  • 8 Voermans R P, van Berge H, Bemelman W A. et al . Novel over-the-scope clip system for gastrostomy closure in natural orifice transluminal endoscopic surgery (NOTES): an ex vivo comparison study.  Endoscopy. 2009;  41 1052-1055
  • 9 Renteln D von, Kaehler G, Eickhoff A. et al . Gastric full-thickness suturing following NOTES procedures for closure of the access site to the peritoneal cavity.  Endoscopy. 2008;  40 E99-E100
  • 10 Arezzo A, Kratt T, Schurr M O. et al . Laparoscopic-assisted transgastric cholecystectomy and secure endoscopic closure of the transgastric defect in a survival porcine model.  Endoscopy. 2009;  41 767-772
  • 11 Kirschniak A, Traub F, Kueper M A. et al . Endoscopic treatment of gastric perforation caused by acute necrotizing pancreatitis using over-the-scope clips: a case report.  Endoscopy. 2007;  39 1100-1002
  • 12 Kirschniak A, Kratt T, Stüker D. et al . A new endoscopic over-the-scope clip system for treatment of lesions and bleeding in the GI tract: first clinical experiences.  Gastrointest Endosc. 2007;  66 162-167
  • 13 Repici A, Arezzo A, de Caro G. et al . Clinical experience with a new endoscopic over-the-scope clip system for use in the GI tract.  Digest Liver Dis. 2009;  41 406-410
  • 14 Van Bodegraven A A, Kuipers E J, Bonenkamp H J. et al . Esophagopleural fistula treated endoscopically with argon beam electrocoagulation and clips.  Gastrointest Endosc. 1999;  50 407-409
  • 15 Wedemeyer J, Schneider A, Manns M P. et al . Endoscopic vacuum-assisted closure of upper intestinal anastomotic leaks.  Gastrointest Endosc. 2008;  67 708-711

J. PohlMD 

Department of Internal Medicine II
Dr. Horst Schmidt-Klinik

Ludwig-Erhard-Str. 100
65199 Wiesbaden
Germany

Fax: +49-611-432418

Email: juergen.pohl@hsk-wiesbaden.de

    >