scholarly journals Endoscopic Management of Anastomotic Leakage after Esophageal Surgery - Ten Year Analysis in a Tertiary University Center

2021 ◽  
Author(s):  
Nader El-Sourani ◽  
Sorin Miftode ◽  
Maximilian Bockhorn ◽  
Alexander Arlt ◽  
Christian Meinhardt
Keyword(s):  
Anastomotic Leakage ◽  
Esophageal Surgery ◽  
Endoscopic Management ◽  
University Center

Endoscopic management of anastomotic leakage after gastrectomy for gastric cancer: how efficacious is it?

2012 ◽  
Vol 48 (1) ◽  
pp. 111-118 ◽  
Author(s):  
Yu Jin Kim ◽  
Sung Kwan Shin ◽  
Hyun Jung Lee ◽  
Hyun Soo Chung ◽  
Yong Chan Lee ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Anastomotic Leakage ◽  
Endoscopic Management

PS01.208: SURVEY ON THE MANAGEMENT OF ANASTOMOTIC LEAKAGE AFTER ESOPHAGEAL RESECTION WITH GASTRIC TUBE RECONSTRUCTION

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 108-109
Author(s):  
Eliza Hagens ◽  
Maarten Anderegg ◽  
Mark I Van Berge Henegouwen ◽  
Suzanne Gisbertz
Keyword(s):  
Anastomotic Leakage ◽  
Gastric Tube ◽  
Locally Advanced ◽  
Treatment Guideline ◽  
Esophageal Resection ◽  
Esophageal Surgery ◽  
International Guideline ◽  
Radio Therapy ◽  
First Choice ◽  
Gastric Tube Reconstruction

Abstract Background For patients with locally advanced esophageal cancer, radical esophageal resection with gastric tube reconstruction preceded by chemo(radio)therapy offers the best chance for cure. Anastomotic leakage (AL) is one of the most severe complications following esophageal surgery, leading to significant morbidity, prolonged hospital stay, considerable costs, decreased quality of life and increased mortality. Management is complicated and not standardized. The objective is to gain insight into the different opinions on AL management among upper gastrointestinal surgeons and to verify the need for a diagnostic and treatment guideline. Methods Surgeons with particular interest in esophageal surgery, were invited to participate in an online questionnaire. The survey consisted of questions pertaining to the surgeons’ experience, operation characteristics, management routine and their opinion on international guidelines on the diagnosis and therapy of AL. Results Of the 331 invited physicians, 40% participated in the survey. 90.7% Use laboratory diagnostics and 62.8% imaging and/or endoscopy postoperatively on routine basis. In case of suspected AL, the first choice of diagnostic imaging modalities was mostly a CT scan (35.7%) or a dynamic swallow investigation (33.3%). In case of AL, indepently of the clincal manifestations (local symptoms only, medianstinal manifestations or In case of gastric conduit necrosis) the treatment strategies differed widely between surgeons (table 1). Over 70% of the responders agree that there is a need for a solid international guideline on AL management. Conclusion There is no general consensus in the management of AL. There is a need for an international guideline regarding the optimal management of AL. Disclosure All authors have declared no conflicts of interest.

Endoscopic vacuum therapy versus stenting for postoperative esophago-enteric anastomotic leakage: systematic review and meta-analysis

Endoscopy ◽  
2020 ◽  
Vol 52 (08) ◽  
pp. 632-642 ◽  
Author(s):  
Pasquale Scognamiglio ◽  
Matthias Reeh ◽  
Karl Karstens ◽  
Eugen Bellon ◽  
Marcus Kantowski ◽  
...  
Keyword(s):  
Systematic Review ◽  
Anastomotic Leakage ◽  
Meta Analysis ◽  
Treatment Success ◽  
Esophageal Surgery ◽  
Metal Stents ◽  
Vacuum Therapy ◽  
Duration Of Treatment ◽  
Median Difference ◽  
Endoscopic Vacuum Therapy

Abstract Background Esophageal anastomotic leakage still represents a challenging complication after esophageal surgery. Endoscopically placed self-expandable metal stents (SEMS) are the treatment of choice, but since the introduction of endoscopic vacuum therapy (EVT) for esophageal leakage 10 years ago, increasing evidence has demonstrated that EVT might be a superior alternative. Therefore, we performed a systematic review and meta-analysis to compare the effectiveness and related morbidity of SEMS and EVT in the treatment of esophageal leak. Methods We systematically searched for studies comparing SEMS and EVT to treat anastomotic leakage after esophageal surgery. Predefined end points including outcome, treatment success, endoscopy, treatment duration, hospitalization time, morbidity, and mortality were assessed and included in the meta-analysis. Results Five retrospective studies including 274 patients matched the inclusion criteria. Compared with stenting, EVT was significantly associated with a higher rate of leak closure (odds ratio [OR] 3.14, 95 % confidence interval [CI] 1.23 to 7.98), more endoscopic device changes (pooled median difference of 3.09; 95 %CI 1.54 to 4.64]), a shorter duration of treatment (pooled median difference –11.90 days; 95 %CI –18.59 to –5.21 days), and a lower mortality rate (OR 0.39, 95 %CI 0.18 to 0.83). There were no significant differences in short-term and major complications. Conclusions Owing to the retrospective quality of the studies with potential biases, the results of the meta-analysis must be interpreted with caution. However, the analysis indicates the potential benefit of EVT, which should be further investigated with standardized and prospectively collected data.

Calcification of Arteries Supplying the Gastric Tube: A New Risk Factor for Anastomotic Leakage after Esophageal Surgery

Radiology ◽  
2015 ◽  
Vol 274 (1) ◽  
pp. 124-132 ◽  
Author(s):  
Peter S. N. van Rossum ◽  
Leonie Haverkamp ◽  
Helena M. Verkooijen ◽  
Maarten S. van Leeuwen ◽  
Richard van Hillegersberg ◽  
...  
Keyword(s):  
Risk Factor ◽  
Anastomotic Leakage ◽  
Gastric Tube ◽  
Esophageal Surgery

Efficacy of the endoscopic management of postoperative fistulas of leakages after esophageal surgery for cancer: a retrospective series

2016 ◽  
Vol 30 (11) ◽  
pp. 4895-4903 ◽  
Author(s):  
Jean-Michel Gonzalez ◽  
C. Servajean ◽  
B. Aider ◽  
M. Gasmi ◽  
X. B. D’Journo ◽  
...  
Keyword(s):  
Esophageal Surgery ◽  
Endoscopic Management

scholarly journals Towards optimal intraoperative conditions in esophageal surgery: A review of literature for the prevention of esophageal anastomotic leakage

2018 ◽  
Vol 54 ◽  
pp. 113-123 ◽  
Author(s):  
Boukje Titia Bootsma ◽  
Daitlin Esmee Huisman ◽  
Victor Dirk Plat ◽  
Linda Jeanne Schoonmade ◽  
Jurre Stens ◽  
...  
Keyword(s):  
Anastomotic Leakage ◽  
Esophageal Surgery ◽  
Review Of Literature

scholarly journals Economic Burden of Endoscopic Vacuum Therapy Compared to Alternative Therapy Methods in Patients with Anastomotic Leakage After Esophagectomy

2021 ◽  
Author(s):  
Ann-Kathrin Eichelmann ◽  
Sarah Ismail ◽  
Jennifer Merten ◽  
Patrycja Slepecka ◽  
Daniel Palmes ◽  
...  
Keyword(s):  
Anastomotic Leakage ◽  
Alternative Therapy ◽  
Patient Treatment ◽  
Endoscopic Management ◽  
Vacuum Therapy ◽  
Ivor Lewis ◽  
Icu Stay ◽  
Reduction Strategies ◽  
Endoscopic Vacuum Therapy ◽  
Mean Cost

Abstract Background Endoscopic vacuum therapy (EVT) has become a promising option in the management of anastomotic leakage (AL) after esophagectomy. However, EVT is an effortful approach associated with multiple interventions. In this study, we conduct a comparative cost analysis for methods of management of AL. Methods All patients who experienced AL treated by EVT, stent, or reoperation following Ivor Lewis esophagectomy for esophageal cancer were included. Cases that were managed by more than one modality were excluded. For the remaining cases, in-patient treatment cost was collected for material, personnel, (par)enteral nutrition, intensive care, operating room, and imaging. Results 42 patients were treated as follows: EVT n = 25, stent n = 13, and reoperation n = 4. The mean duration of therapy as well as length of overall hospital stay was significantly shorter in the stent than the EVT group (30 vs. 44d, p = 0.046; 34 vs. 53d, p = 0.02). The total mean cost for stent was €33.685, and the total cost for EVT was €46.136, resulting in a delta increase of 37% for EVT vs. stent cost. 75% (€34.320, EVT), respectively, 80% (€26.900, stent) of total costs were caused by ICU stay. Mean pure costs for endoscopic management were relatively low and comparable between both groups (EVT: €1.900, stent: €1.100, p = 0.28). Conclusion Management of AL represents an effortful approach that results in high overall costs. The expenses directly related to EVT and stent therapy were however comparatively low with more than 75% of costs being attributable to the ICU stay. Reduction of ICU care should be a central part of cost reduction strategies.

scholarly journals Peripheral blood inflammation indices are effective predictors of anastomotic leakage in elective esophageal surgery

2021 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Cai-Xia Wu ◽  
Ding-Yu Rao ◽  
Cheng-Peng Sang ◽  
Shen-Yu Zhu ◽  
Liang Gu ◽  
...  
Keyword(s):  
Anastomotic Leakage ◽  
Peripheral Blood ◽  
Esophageal Surgery
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