Endoscopy 2022; 54(S 01): S193-S194
DOI: 10.1055/s-0042-1745092
Abstracts | ESGE Days 2022
ESGE Days 2022 Digital poster exhibition

ENDOSCOPIC MANAGEMENT OF OESOPHAGEAL PERFORATIONS AND LEAKS- 5 YEARS SINGLE CENTRE EXPERIENCE

Authors

  • P. Karagyozov

    1   Acibadem City Clinic Tokuda University Hospital, Interventional Gastroenterology, Sofia, Bulgaria

  • I. Zhecheva

    1   Acibadem City Clinic Tokuda University Hospital, Interventional Gastroenterology, Sofia, Bulgaria

  • I. Tishkov

    1   Acibadem City Clinic Tokuda University Hospital, Interventional Gastroenterology, Sofia, Bulgaria

  • T. Minchev

    2   Acibadem City Clinic Tokuda University Hospital, Thoracic Surgery, Sofia, Bulgaria
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Aims The aim of this study is to assess the technical success and outcome of different endoscopic treatment modalities in patients with esophageal perforations.

Methods

  • Data was collected retrospectively from May 2017 to September 2021.

  • We present a case series of 10 patients (N=10, 9 men, 1 woman) treated in our unit with iatrogenic and spontaneous oesophageal perforations or anastomotic dehiscences after oesophageal surgery.

Results

  • The most common etiology for perforation was iatrogenic or insufficiency of esophagogastric or esophagojejunal anastomosis.

  • All of the patients underwent Computed tomography (CT) of the chest and gastrodoudenoscopy.

  • Patients were categorized into four treatment groups: 3 primary closures (endoscopic clip placement ), 1 primary diversion (stent placement ), 5 combination therapy (endoscopic clip closure, followed by stent placement ), and 1 endoscopic vacum terapy.

  • Techical and long-term clinical success was achieved in 90% of the patients.

  • There was one death due to sepsis and multiple organ failure.

  • None of the patients required surgical repair.

Conclusions Endoscopic management of acute esophageal perforation is emerging as the primary treatment modality and is less invasive and morbid than surgery. Combination strategies including OTSC clip-closure followed by stenting demonstrates best results with low morbidity and mortality.


Publication History

Article published online:
14 April 2022

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