title: Endoscopic placement of fully covered self expanding metal stents for management of post-operative foregut leaks.
abstract: BACKGROUND
  Fully covered self-expanding metal stent (SEMS) placement has been successfully described for the treatment of malignant and benign conditions. The aim of this study is to evaluate our experience of fully covered SEMS placement for post-operative foregut leaks.
  
  
  METHODS
  Retrospective analysis was done for indications, outcomes and complications of SEMS placed in homogeneous population of 15 patients with post-operative foregut leaks in our tertiary-care centre from December 2008 to December 2010. Stent placement and removal, clinical and radiological evidence of leak healing, migration and other complications were the main outcomes analyzed.
  
  
  RESULTS
  Twenty-three HANAROSTENT(®) SEMS were successfully placed in 14/15 patients (93%) with post-operative foregut leaks for an average duration of 28.73 days (range=1-42 days) per patient and 18.73 days per SEMS. Three (20%) patients needed to be re-stented for persistent leaks ultimately resulting in leak closure. Total 5/15 (33.33%) patients and 7/23 (30.43%) stents showed migration; 5/7 (71.42%) migrated stents could be retrieved endoscopically. There were mucosal ulceration in 2/15 (13.33%) and pain in 1/15 (6.66%) patients.
  
  
  CONCLUSIONS
  Stenting with SEMS seems to be a feasible option as a primary care modality for patients with post-operative foregut leaks.
authors.affiliation: IRCAD/EITS, Department of Gastrointestinal and Endocrinal Surgery, University of Strasbourg, Strasbourg, France.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Donatelli
authors.forename: Parag
authors.initials: P
authors.lastname: Dhumane
authors.forename: Silvana
authors.initials: S
authors.lastname: Perretta
authors.forename: Bernard
authors.initials: B
authors.lastname: Dallemagne
authors.forename: Michele
authors.initials: M
authors.lastname: Vix
authors.forename: Didier
authors.initials: D
authors.lastname: Mutter
authors.forename: Stavros
authors.initials: S
authors.lastname: Dritsas
authors.forename: Michel
authors.initials: M
authors.lastname: Doffoel
authors.forename: Jacques
authors.initials: J
authors.lastname: Marescaux