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食管支架治疗吻合口漏的疗效。

Outcomes of Esophageal Stent Therapy for the Management of Anastomotic Leaks.

机构信息

Division of Surgical Oncology, Department of Surgery, University of Louisville School of Medicine, Louisville, KY, USA.

出版信息

Ann Surg Oncol. 2021 Sep;28(9):4960-4966. doi: 10.1245/s10434-021-09669-6. Epub 2021 Mar 17.

Abstract

BACKGROUND

The purpose of this study was to present the optimal patient selection for esophageal stenting after esophageal resection to investigate possible factors leading to treatment success or treatment failure in these patients.

METHODS

This was a prospective, observational study of patients from January 2005 to May 2019 with an esophageal anastomotic leak that were treated with a self-expandable stent (SES).

RESULTS

A total of 34 patients were treated. All achieved technical success (100%); 33 (97%) achieved clinical success. No patient had to have reoperative surgery based on their leak management. The stenting in-hospital mortality was 0% with 1 patient (2%) with a 90-day mortality from possible leak-related death. Patients had their stents removed with a median of 106 days.

CONCLUSIONS

Stenting for an anastomotic leak after resection offers a safe and effective method of treatment and is successful in the majority of cases. Critical to success is optimal patient selection, adequate leak drainage, and optimal stent selection and placement.

摘要

背景

本研究旨在为食管切除术后食管支架置入术的最佳患者选择提供指导,以探讨导致这些患者治疗成功或失败的可能因素。

方法

这是一项对 2005 年 1 月至 2019 年 5 月期间因食管吻合口瘘接受自膨式支架(SES)治疗的患者进行的前瞻性观察研究。

结果

共治疗了 34 例患者。所有患者均达到技术成功(100%);33 例(97%)达到临床成功。没有患者因漏管管理而需要再次手术。支架置入院内死亡率为 0%,1 例患者(2%)在 90 天内死于可能与漏管相关的死亡。患者中位带支架时间为 106 天。

结论

切除术后吻合口瘘支架置入术是一种安全有效的治疗方法,在大多数情况下是成功的。成功的关键是最佳的患者选择、充分的漏管引流以及最佳的支架选择和放置。

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