TREATMENT OF ESOPHAGOJEJUNAL ANASTOMOSIS LEAKAGE AFTER GASTRECTOMY USING SELF-EXPANDABLE STENTS
DOI:
https://doi.org/10.11603/2414-4533.2024.4.15015Keywords:
ailure of esophageal-small-intestinal anastomosis, gastrectomy, endoscopic VAC-system, self-expanding metal stentAbstract
The aim of the work: to determine the impact of stenting failure of esophageal-small-intestinal anastomoses on the number of disabling surgical interventions.
Materials and Methods. We analyzed the medical records of patients who underwent surgery for gastric cancer between 2018 and 2022 at the National Cancer Institute of Ukraine. Out of 613 patients who underwent gastrectomy, 48 (7.8 %) developed EJA leakage. Patients were categorized into four groups based on the severity of the condition. Group 1 (9 patients, 18.7 %) – leakage identified only through radiological signs. Group 2 (19 patients, 39.5 %) – leakage involving less than 10 % of the anastomotic circumference. Group 3 (18 patients, 37.5 %) – leakage involving 10–50 % of the circumference, accompanied by a paraanastomotic abscess. Group 4 (2 patients, 4.4 %) – necrosis and rupture involving more than 50 % of the circumference.
Results. SEMS placement was performed as the primary treatment for 16 patients (75 %), while 4 patients declined the procedure. Six patients from groups 3 and 4 required reoperations, including Torek procedures. Among patients treated with SEMS, 70 % achieved complete healing. Self-expandable stents are well-established as a palliative treatment for advanced esophageal cancer with grade 3–4 dysphagia. This study confirms their efficacy in managing EJA leakage following gastrectomy, further supporting their use in this context.
Conclusions. SEMS offer a safe and effective solution for EJA leakage, making them a valuable addition to clinical practice for managing this challenging condition. This version uses concise, professional phrasing and ensures a smoother flow, making it more in line with native English academic standards.
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