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Original Article
GE Port J Gastroenterol 2017;24:169–175
DOI: 10.1159/000453115
Treatment of Postoperative Leaks of
the Upper Gastrointestinal Tract with
Colonic Self-Expandable Metal Stents
Paula Sousa António Castanheira Diana Martins Juliana Pinho
Ricardo Araújo Eugénia Cancela Paula Ministro Américo Silva
Gastroenterology Department, Centro Hospitalar Tondela/Viseu, Viseu, Portugal
syndrome, and an esophagectomy due to esophageal can-
cer. The leaks were detected on average 17 days after the
initial surgery. All patients needed admission to a critical care
unit after index surgery. Stent placement was technically
feasible in all patients. The median residence time of the
stents was 7 weeks, and no complications were verified
when they were removed. There were no cases of stent mi-
gration. The treatment was successful in all patients, with
complete healing of the leaks. Discussion and Conclusions:
The placement of colonic FSEMS seems to be successful and
safe in the treatment of postoperative leaks of the upper gas-
trointestinal tract. © 2016 Sociedade Portuguesa de Gastrenterologia
Published by S. Karger AG, Basel
Tratamento de Deiscências e Fístulas Cirúrgicas do
Trato Gastrointestinal Alto com Próteses Metálicas
Autoexpansíveis do Cólon
Palavras Chave
Fístula anastomótica · Doenças gastrointestinais ·
Complicações pós-operatórias · Stents metálicos
autoexpansíveis
Keywords
Anastomotic leak · Gastrointestinal diseases · Postoperative
complications · Self-expandable metallic stents
Abstract
Introduction: The use of self-expandable metal stents (SEMS)
for the treatment of postoperative leaks of the upper gastro-
intestinal tract is already established. However, there are dis-
crepancies between the relatively small caliber of the esoph-
ageal stents available and the postsurgical luminal size,
which may determine an inadequate juxtaposition. As co-
lonic stents have a bigger diameter, they might be more ad-
equate. Additionally, stents with a larger diameter might
have a lower risk of migration. Materials and Methods: The
aim of this study was to evaluate the efficacy and complica-
tions associated with the use of colonic fully covered SEMS
(FSEMS) in the treatment of postoperative leaks in critical pa-
tients. All patients with postoperative leaks of the upper gas-
trointestinal tract treated with colonic stents (Hanarostent
®
CCI) between 2010 and 2013 were retrospectively included.
Results: Four patients with postoperative leaks were treated
with colonic SEMS. The underlying surgeries were a gastric
bypass, an esophagogastrectomy for Boerhaave syndrome,
a primary repair of esophagopleural fistula due to Boerhaave
Received: July 25,2016
Accepted after revision: October 30, 2016
Published online: December 21, 2016
Dr. Paula Sousa
Gastroenterology Department, Centro Hospitalar Tondela/Viseu
Av. Rei D. Duarte
PT–3504-509 Viseu (Portugal)
E-Mail paulacrfsousa @ gmail.com
© 2016 Sociedade Portuguesa de Gastrenterologia
Published by S. Karger AG, Basel
www.karger.com/pjg
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