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Conservative reconstruction using stents as salvage therapy for disruption of esophago-gastric anastomosis.
- Source :
-
World journal of gastroenterology [World J Gastroenterol] 2015 Jul 28; Vol. 21 (28), pp. 8723-9. - Publication Year :
- 2015
-
Abstract
- Esophagectomy with extended lymphadenectomy and gastric conduit reconstruction is a radical procedure for the treatment of esophageal cancer that is associated with a high morbidity rate. Gastric conduit necrosis is a fatal complication that occurs in 2% of patients. Conventionally, two-stage salvage surgery consisting of removal of the necrotic gastric conduit followed by reconstruction has been performed; however, this procedure has a high morbidity rate. We describe a 61-year-old man who underwent minimally invasive esophagectomy complicated by slowly progressive gastric conduit necrosis associated with complete neck drainage and a stable overall condition. There was a 2 cm gap in the anastomosis. Because there was no evidence of residual gastric conduit necrosis, a removable, covered self-expanding metal stent (SEMS) was inserted to bridge the anastomosis. The stent was fixed to the patient's ear with silk thread through the lasso on its proximal end to prevent migration. Eight weeks after insertion, the stent was removed easily without any associated complications. The anastomotic defect was completely bridged with granulation tissue, showing progressive epithelialization without leakage or stenosis. The patient was discharged home in good general health. This is the first report of the successful conservative management of esophago-gastric conduit anastomosis disruption with SEMS placement.
- Subjects :
- Anastomosis, Surgical
Carcinoma, Squamous Cell pathology
Esophageal Neoplasms pathology
Esophageal Squamous Cell Carcinoma
Humans
Male
Middle Aged
Necrosis
Postoperative Complications diagnosis
Postoperative Complications etiology
Prosthesis Design
Plastic Surgery Procedures adverse effects
Reoperation
Stomach pathology
Tomography, X-Ray Computed
Treatment Outcome
Carcinoma, Squamous Cell surgery
Esophageal Neoplasms surgery
Esophagectomy
Esophagoscopy instrumentation
Postoperative Complications surgery
Plastic Surgery Procedures instrumentation
Stents
Stomach surgery
Subjects
Details
- Language :
- English
- ISSN :
- 2219-2840
- Volume :
- 21
- Issue :
- 28
- Database :
- MEDLINE
- Journal :
- World journal of gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 26229414
- Full Text :
- https://doi.org/10.3748/wjg.v21.i28.8723