Use of Polyflex stents in treatment of acute esophageal and gastric leaks after bariatric surgery.
BACKGROUND
This study examined the feasibility of using Polyflex stents in the treatment of enteric leaks after various bariatric operations. Chronic and acute leaks were treated.


METHODS
We performed a retrospective case series review. Four patients received 6 Polyflex stents to treat complications of bariatric surgery. Two presented with early sepsis before stenting. One presented with abdominal pain. One presented with a chronic persistent fistula with an associated abscess. Stenting was performed under endoscopy with fluoroscopic guidance. The stents were left in place for 6 weeks.


RESULTS
All patients tolerated a clear liquid diet within 24 hours of stenting and were able to be advanced to a pureed diet. All patients improved clinically after stenting. Three patients with acute leaks sealed their leaks after stent placement. One patient with a chronic leak persisted and required operative closure after a second stent was placed and failed. All patients experienced short-term nausea, as well as early satiety that lasted the duration of the stenting. One patient experienced hypersialisis while the stent was in place. Two stents migrated, although this had no effect on leak closure. One patient had an anastomotic stenosis successfully treated with a second stent.


CONCLUSIONS
Polyflex stents are useful in bypassing acute upper intestinal leaks after various bariatric operations. They provide a temporary bridge for wound healing with continued oral intake. Stenting provides a minimally invasive option in the management of acute leaks and, in our experience, had no serious associated morbidity.
Fukumoto
Royd
R
Department of Surgery, St.Luke's Roosevelt Hospital, New York, New York, USA.
Orlina
Jeraldine
J
McGinty
James
J
Teixeira
Julio
J
D000328:Adult; D050110:Bariatric Surgery / Q000009:adverse effects*; D016145:Endoscopy, Digestive System; D004935:Esophageal Diseases / Q000209:etiology / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D015607:Stents; D013272:Stomach Diseases / Q000209:etiology / Q000628:therapy*