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经覆膜自膨式金属支架成功治疗食管颈段严重吻合口瘘。

Successful closure with covered self-expandable metal stent for severe anastomotic leakage in the cervical esophagus.

机构信息

Department of Gastroenterology, Hiroshima Red Cross Hospital & Atomic-Bomb Survivors Hospital, 1-9-6, Sendamachi, Naka-ku, Hiroshima, 730-8619, Japan.

Department of Surgery, Hiroshima Red Cross Hospital & Atomic-Bomb Survivors Hospital, 1-9-6, Sendamachi, Naka-ku, Hiroshima, 730-8619, Japan.

出版信息

Clin J Gastroenterol. 2021 Jun;14(3):714-717. doi: 10.1007/s12328-021-01381-y. Epub 2021 Mar 20.

Abstract

Anastomotic leakage is one of the major complications of esophageal surgery with a high mortality rate and significant morbidity. We describe a case of severe anastomotic leakage close to the hypopharynx after esophageal cancer resection. Despite the conservative management with external drainage, the severe leak did not improve. A fully covered self-expandable metal stent (SEMS) with short flares, which was designed for the cervical esophagus, was subsequently placed bridging the anastomosis to seal the fistula. The post-procedural course was uneventful, and the stent was endoscopically removed after three weeks without any complications. The patient was discharged home three weeks after the stent removal. Our results suggest that placement of fully covered SEMS with short flares may be a safe and effective treatment in this condition of patients.

摘要

吻合口瘘是食管手术后的主要并发症之一,具有较高的死亡率和显著的发病率。我们描述了一例食管癌切除术后靠近咽下部的严重吻合口瘘病例。尽管采用了外部引流的保守治疗,但严重的漏口并未改善。随后放置了一个设计用于颈段食管的短喇叭口全覆膜自膨式金属支架(SEMS),以桥接吻合口来封闭瘘口。术后过程顺利,支架在 3 周后无任何并发症被内镜取出。支架取出 3 周后,患者出院回家。我们的结果表明,对于这种情况的患者,放置短喇叭口全覆膜 SEMS 可能是一种安全有效的治疗方法。

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