Novel esophageal stent for treatment of cervical anastomotic leakage after esophagectomy

Abstract

Background

Dedicated stents for treatment of cervical anastomotic leakage are currently unavailable. In this study, we aimed to assess the feasibility and efficacy of using custom-designed stents for treatment of cervical anastomotic leakage after esophagectomy.

Methods

The stents were designed according to the location and size of the leakage and the residual esophageal length as determined by esophagography in each case. It had a cup-shaped upper end and a globular lower end and a total height of 60–85 mm. The diameter of the upper cup-shaped part was 24–26 mm and the length 20–25 mm. The cup part and the stent main body were connected at a right angle. Data from cervical anastomotic leakage patients treated with these stents were retrospectively analyzed.

Results

Data from a total of 27 patients with cervical anastomotic leakage were retrospectively analyzed. The custom-designed esophageal covered stents were placed successfully at the first attempt in 24 cases (88.9%). The total operative time was 5–15 min. The stents were removed 7 days to 3 months after leakage healing. Follow-up showed no leakage recurrence; three patients had anastomosis scar strictures. Fifteen patients died (median survival 13.4 months) and nine survived.

Conclusion

Placement of the novel esophageal covered stent is a minimally invasive, efficacious treatment option for the patients with cervical anastomotic leakage after esophagectomy.

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