title: Treatment of anastomotic leaks with metallic stent after esophagectomies.
abstract: The diagnosis and the treatment of anastomotic leak after esophagectomy are the keys to reduce the morbidity and mortality after this surgery. The stent plays an important role in the treatment of the leakage and in the prevention of reoperation. We have analyzed the database of the section of the esophagogastric surgery of Donostia University Hospital from June 2003 to May 2012. It is a retrospective study of 113 patients with esophagectomy resulting from tumor, and 24 (21.13%) of these patients developed anastomotic leak. Of these 24 patients, 13 (54.16%) have been treated with a metallic stent and 11 (45.84%) without a stent. The average age of the patients was 55.69 and 62.45 years, respectively. All patients treated with and without a stent have been males. Eight (61.5%) stents were placed in the neck and five (38.5%) in the chest. However, among the 11 fistulas treated without a stent, 9 patients had cervical anastomosis (81.81%) and 2 patients (18.18%) had anastomosis in the chest. Twelve patients (92.30%) with a stent preserve digestive continuity, and 10 patients (90.90%) were treated without a stent. One patient died in the stent group and one in the nonstent group. The treatment with metallic stent of the anastomotic leak after esophagectomy is an option that can prevent reoperation in these patients, but it does not decrease the average of the hospital stay. The stent may be more useful in thoracic anastomotic leaks.
authors.affiliation: Department of Esophagogastric Surgery, Donostia University Hospital, Donostia-San Sebastian, Basque Country, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Eizaguirre
authors.affiliation: Department of Esophagogastric Surgery, Donostia University Hospital, Donostia-San Sebastian, Basque Country, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Larburu
authors.affiliation: Department of Esophagogastric Surgery, Donostia University Hospital, Donostia-San Sebastian, Basque Country, Spain.
authors.forename: J I
authors.initials: JI
authors.lastname: Asensio
authors.affiliation: Department of Esophagogastric Surgery, Donostia University Hospital, Donostia-San Sebastian, Basque Country, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Rodriguez
authors.affiliation: Department of Esophagogastric Surgery, Donostia University Hospital, Donostia-San Sebastian, Basque Country, Spain.
authors.forename: J L
authors.initials: JL
authors.lastname: Elorza
authors.affiliation: Department of Interventional Radiology, Donostia University Hospital, Donostia-San Sebastian, Basque Country, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Loyola
authors.affiliation: Department of Digestive Endoscopy, Donostia University Hospital, Donostia-San Sebastian, Basque Country, Spain.
authors.forename: G
authors.initials: G
authors.lastname: Urdapilleta
authors.affiliation: Department of Esophagogastric Surgery, Donostia University Hospital, Donostia-San Sebastian, Basque Country, Spain.
authors.forename: J M E
authors.initials: JM
authors.lastname: Navascués
mesh_terms: D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D057868:Anastomotic Leak / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D004938:Esophageal Neoplasms / Q000401:mortality / Q000601:surgery; D016629:Esophagectomy / Q000009:adverse effects / Q000379:methods; D004945:Esophagoscopy / Q000379:methods; D004947:Esophagus / Q000473:pathology / Q000601:surgery; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012086:Reoperation / Q000379:methods / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013030:Spain; D015607:Stents
keywords: anastomosis; esophagectomy; leak; stent