title: Management of anastomotic leaks after Roux-en-Y bypass using self-expanding polyester stents.
abstract: BACKGROUND
  To analyze the outcomes of a series of endoscopically placed polyester self-expanding polyflex stents (SEPSs) for the management of anastomotic leaks after Roux-en-Y bypass. Anastomotic leaks after gastric bypass cause significant morbidity and mortality. Covered polyester SEPSs might have a role in the treatment of these leaks.
  
  
  METHODS
  A retrospective chart review was performed from January 2006 to November 2006 that included all acute and chronic leaks treated with SEPSs.
  
  
  RESULTS
  A total of 6 patients were treated with stents, with a mean procedure time of 22 minutes. Of these 6 patients, 5 had acute postoperative leaks and 1 had a chronic fistula. Five patients started oral intake 1-6 days after their procedure. All acute leaks had complete healing at a median of 44 days. The patient with a chronic gastrocutaneous fistula required revisional surgery for fistula closure. In addition, 5 patients had stent migration, and 3 required stent replacement.
  
  
  CONCLUSIONS
  An endoscopically placed SEPS provides a less-invasive alternative to treat acute anastomotic leaks after Roux-en-Y bypass while simultaneously allowing oral intake. The results of this case series have demonstrated this treatment to be safe and effective.
authors: Department of Surgery, University of Missouri-Columbia, Columbia, Missouri 65212, USA.
authors: Christopher A
authors: CA
authors: Edwards
authors: T Phiet
authors: TP
authors: Bui
authors: J Andrés
authors: JA
authors: Astudillo
authors: Roger A
authors: RA
authors: de la Torre
authors: Brent W
authors: BW
authors: Miedema
authors: Archana
authors: A
authors: Ramaswamy
authors: Nicole M
authors: NM
authors: Fearing
authors: Bruce J
authors: BJ
authors: Ramshaw
authors: Klaus
authors: K
authors: Thaler
authors: J Stephen
authors: JS
authors: Scott
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical / Q000009:adverse effects*; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000601:surgery; D011091:Polyesters; D011183:Postoperative Complications; D012086:Reoperation / Q000295:instrumentation; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome
chemical_list: D011091:Polyesters