van Wezenbeek Martin R, de Milliano Martine M, Nienhuijs Simon W, Friederich Pieter, Gilissen Lennard P L
Department of Surgery, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands.
Department of Bariatric Surgery, Catharina Hospital, P.O. Box 1350, 5602 ZA, Eindhoven, The Netherlands.
Obes Surg. 2016 Aug;26(8):1875-80. doi: 10.1007/s11695-015-2027-6.
The management of anastomotic leakage after either laparoscopic Roux-en-Y gastric bypass (LGBP) or laparoscopic sleeve gastrectomy (LSG) remains a burden. Various options are available for the treatment of these leaks. A newer and less invasive option for the treatment of leaks is the use of endoluminal stents. The main drawback for this treatment is stent migration. The current study describes the outcome of a new, specifically designed stent for the treatment of anastomotic leaks after bariatric surgery.
For this retrospective observational study, the medical charts of patients undergoing bariatric surgery between October 1, 2010 and July 1, 2013 were reviewed. All patients with anastomotic leakage, treated with the bariatric Hanarostent, were included.
Twelve patients were included out of a total of 1702 bariatric patients in the described period. Seven had a leakage after LSG, five after LGBP. An average of 2.4 endoscopic procedures and 1.25 stents were used per patient. Successful treatment was seen in nine out of 12 patients (75 %). Most common complication was dislocation or migration of the stent, occurring in eight patients (66.7 %).
The ECBB Hanarostent®, which was specifically designed for post bariatric leakages, shows equal but not favorable success rates in this small series compared to previous reports on other types of stenting techniques. Despite the stent design, the complication rate is not reduced and the main future goal should be to target the high stent migration rate.
腹腔镜Roux-en-Y胃旁路术（LGBP）或腹腔镜袖状胃切除术（LSG）后吻合口漏的处理仍然是一个难题。治疗这些漏口有多种选择。一种更新的、侵入性较小的漏口治疗选择是使用腔内支架。这种治疗的主要缺点是支架移位。本研究描述了一种专门设计的新型支架用于治疗减重手术后吻合口漏的结果。
对于这项回顾性观察研究，我们回顾了2010年10月1日至2013年7月1日期间接受减重手术患者的病历。纳入所有使用减重Hanarostent支架治疗吻合口漏的患者。
在所描述的时期内，1702例减重患者中共有12例被纳入研究。7例患者在LSG后发生漏口，5例在LGBP后发生漏口。每位患者平均进行2.4次内镜操作，使用1.25个支架。12例患者中有9例（75%）治疗成功。最常见的并发症是支架脱位或移位，8例患者（66.7%）出现此情况。
专门为减重术后漏口设计的ECBB Hanarostent®，在这个小系列研究中与先前关于其他类型支架技术的报告相比，成功率相当但并不理想。尽管有支架设计，但并发症发生率并未降低，未来的主要目标应该是针对高支架移位率。
