Fernández Alberto, González-Carrera Víctor, González-Portela Carlos, Carmona Amalia, de-la-Iglesia Manuel, Vázquez Santiago
Aparato Digestivo, Hospital POVISA, España.
Hospital POVISA de Vigo.
Rev Esp Enferm Dig. 2015 Oct;107(10):608-13. doi: 10.17235/reed.2015.3765/2015.
The use of fully covered metal stents (FCMS) for the treatment of benign conditions is increasing. The aim of our study was to assess the efficacy of FCMS in the management of post-operative leaks after gastric or esophageal surgery.
During a three year period (2011-2013), patients who underwent a surgery related with esophageal or gastric cancer and developed a postoperative anastomotic leak treated with FCMS were prospectively included.
Fourteen patients were included (11 men, 3 women), with median age of 65 years. Placement of at least one stent was achieved in 13 patients (93% of cases), with initial closure of the leak in 12 of these 13 cases (92.3%). A final success (after removal of the stent) could be demonstrated in 9 cases (69.2%, intention to treat analysis); stent failed only in one case (7.7%) and there were 3 patients (23.1%) not evaluated because death before stent retrieval (not related with the endoscopic procedure). One stent were used in 9 cases (69.2%), and two in 4 (30.8%). Migration was observed in two cases (15.3%). There were no major complications related with the use of stents. There were no complications related with retrieval.
The placement of FCMS to achieve the leak closure after esophageal or gastric surgery is an effective and probably safe alternative feasible with minor risks.
全覆膜金属支架（FCMS）用于良性疾病治疗的情况日益增多。本研究旨在评估FCMS在治疗胃或食管手术后吻合口漏中的疗效。
在三年期间（2011 - 2013年），前瞻性纳入了接受与食管癌或胃癌相关手术且术后发生吻合口漏并接受FCMS治疗的患者。
纳入14例患者（11例男性，3例女性），中位年龄65岁。13例患者（93%的病例）成功置入至少一枚支架，其中12例（92.3%）漏口初步闭合。9例（69.2%，意向性分析）最终成功（支架取出后）；仅1例（7.7%）支架置入失败，3例患者（23.1%）因在支架取出前死亡（与内镜操作无关）未进行评估。9例（69.2%）使用一枚支架，4例（30.8%）使用两枚支架。观察到2例（15.3%）支架移位。未出现与支架使用相关的严重并发症。支架取出也无并发症。
在食管或胃手术后放置FCMS以实现漏口闭合是一种有效且可能安全的替代方法，风险较小。
