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Surgical treatment of a rare complication after endoscopic stent placement for anastomotic leakage after esophageal resection

Surgical treatment of a rare complication after endoscopic stent placement for anastomotic leakage after esophageal resection

作     者:Marjan Klinkert Mechteld C de Jong Meindert N Sosef Annick B van Nunen Henricus J Belgers 

作者机构:Department of Surgery Zuyderland Medical Centre Department of Gastroenterology Zuy-derland Medical Centre 

出 版 物:《World Journal of Surgical Procedures》 (世界外科手术杂志)

年 卷 期:2017年第7卷第1期

页      面:1-5页

学科分类:10[医学] 

主  题:Esophageal cancer Esophageal obstruction Rendezvous procedure Anterograde dilatation Combined anterograde-retrograde endoscopic dilatation 

摘      要:The best approach to achieve cure in esophageal cancer is a combination of chemo-radiation and surgery. However, complications occur in half of patients. The current report, reports a rare but severe complication: Complete obstruction of the esophagus, induced by preoperative chemo-radiation therapy. Normally, strictures are treated by repeated dilatations, however, in case of complete obstruction, the perforation rate of standard blind anterograde wire access and dilation is severely increased. In order to minimize the risk of perforations, the rendezvous technique was introduced. This technique involves an anterograde approach in combination with a retrograde approach in order to open and dilatate the esophagus. While technical success rates between 83% and 100% have been reported in literature, data on clinical outcomes are scarcer. The limited amount of studies available claim that success was achieved in almost half of patients. The patient in our case currently has an oral diet without restrictions and rates his quality of life with a VAS-score ten out of ten.

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