Abstract

Background Anastomotic stenosis and leakage are rare complications after esophagojejunostomy. The management of complications after esophagojejunostomy remains a challenge. We evaluated the outcomes and clinical effectiveness of an alternative interventional protocol. Objectives To determine the safety and efficacy of interventional treatment for the management of complications after esophagojejunostomy. Methods This study included 24 consecutive patients with complications after esophagojejunostomy treated using interventional protocol. Patients received balloon dilation or stenting for anastomotic stenosis. Patients with anastomotic leakage received three-tube placement or retrievable covered esophageal stent placement, followed by abscess drainage, nutritional support, and anti-inflammatory treatment. The three tubes and esophageal stents were removed after leakage healing and stenosis ceased. Results Thirteen patients received three-tube method, and 16 patients received covered stent placement. All procedures were technically successful, except for a failure of Y-type esophageal stent placement in one patient. The median retention time of stent and abscess drainage tube was 67.5 days and 87 days, respectively. No perioperative death, esophageal rupture, or massive hemorrhage was found during procedures. During follow-up, 14 patients died of cancer recurrence, and one died of severe pulmonary infection. The 1-, 3-, 5-year survival rates were 39.5%, 23.7%, and 23.7%, respectively. Conclusion Interventional protocol is safe, feasible, and efficacious for treatment of complications after esophagojejunostomy.

Highlights

  • Patients with resectable esophagogastric carcinoma are commonly treated with gastrectomy and esophagectomy [1, 2]

  • Complications including anastomotic stenosis and/or anastomotic leakage are rare after esophagojejunostomy [3], with an overall incidence of less than 3.0% [4]

  • We used an interventional protocol consisting of balloon dilation for benign anastomotic stenosis, stent for malignant, and three-tube method with or without covered esophageal stent placement for anastomotic leakage

Read more

Summary

Introduction

Patients with resectable esophagogastric carcinoma are commonly treated with gastrectomy and esophagectomy [1, 2]. Endoscopic placement of covered stents has been used for the treatment of anastomotic leakages after esophagogastrostomy or esophagojejunostomy [9, 10]. We used an interventional protocol consisting of balloon dilation for benign anastomotic stenosis, stent for malignant, and three-tube method with or without covered esophageal stent placement for anastomotic leakage. We aimed to determine the safety and efficacy of this protocol for treatment of complications after esophagojejunostomy. To determine the safety and efficacy of interventional treatment for the management of complications after esophagojejunostomy. This study included 24 consecutive patients with complications after esophagojejunostomy treated using interventional protocol. Patients with anastomotic leakage received three-tube placement or retrievable covered esophageal stent placement, followed by abscess drainage, nutritional support, and anti-inflammatory treatment. Interventional protocol is safe, feasible, and efficacious for treatment of complications after esophagojejunostomy

Objectives
Methods
Results
Conclusion
Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call