306. TREATMENT OF ANASTOMOTIC LEAKS AFTER ESOPHAGECTOMY AND GASTRECTOMY FOR CANCER BY MEANS OF ENDOSCOPIC VACUUM THERAPY

IF 2.3 3区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY
Victor Turrado-Rodriguez, Oriol Sendino, Jordi Farguell Piulachs, Anna Curell Garcia, Ainitze Ibarzabal Olanl, Miguel Pera, Dulce Momblan Garcia
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引用次数: 0

Abstract

Background Esophagectomy and gastrectomy are the cornerstones of the curative treatment of oesophageal and gastric cancer. In both techniques the risk of anastomotic leak (AL) is high, with rates of up to 21% after esophagectomy and up to 12% after gastrectomy. Mortality and morbidity are high after an AL occurs. Several treatment strategies have been developed for treatment of AL, including surgery, endoscopic stent and endoscopic vacuum therapy (EVT). The aim of this study is to analyse the treatment patterns of the patients with AL treated with EVT. Methods All patients diagnosed of gastric or oesophageal cancer with AL from January 2021 to January 2024 were included in a retrospective study. Baseline data, localization of the tumour, type of resection, type of anastomosis, total time with EVT, number of EVTs used per patient, hospital stay, Clavien-Dindo score and CCI were recorded. A descriptive analysis of the data is performed. Results All 18 patients with AL during the study period were treated with EVT. The tumour was located on the distal third of the oesophagus in 7 patients (38.9%), and stomach (27.8%). The median duration from surgery to the identification of AL was 5 days (IQR 4 – 9). The median duration of the EVT treatment was 18 days (IQR 13 – 23) with a median EVT replacement of 5.5 (IQR 4 – 7). 8 patients (44.4%) did not require ICU stay. Median time to resumption of oral intake was 34 days (IQR 26 –54). Success rate of the EVT therapy was 88.9%. Conclusions EVT is a useful tool for the treatment of AL in esophagogastric surgery. Even though the treatment may be long, it’s success rate in this series is 88.9% and it may avoid ICU stay in some cases. A close monitoring of this patients and the prompt use of additional techniques to assure source control is mandatory.
306.通过内窥镜真空疗法治疗癌症食管切除术和胃切除术后的吻合口渗漏
背景 食管切除术和胃切除术是食道癌和胃癌根治性治疗的基石。在这两种技术中,吻合口漏(AL)的风险都很高,食管切除术后高达 21%,胃切除术后高达 12%。发生 AL 后,死亡率和发病率都很高。目前已开发出多种治疗 AL 的策略,包括手术、内镜支架和内镜真空疗法(EVT)。本研究旨在分析采用 EVT 治疗的 AL 患者的治疗模式。方法 回顾性研究纳入了 2021 年 1 月至 2024 年 1 月期间所有确诊为胃癌或食道癌的 AL 患者。研究记录了基线数据、肿瘤定位、切除类型、吻合类型、EVT总时间、每位患者使用的EVT次数、住院时间、Clavien-Dindo评分和CCI。对数据进行了描述性分析。结果 在研究期间,所有18名AL患者均接受了EVT治疗。肿瘤位于食道远端三分之一处的患者有7人(38.9%),位于胃部的患者有27.8%。从手术到发现 AL 的中位时间为 5 天(IQR 4 - 9)。EVT治疗的中位持续时间为18天(IQR 13 - 23),EVT置换的中位时间为5.5天(IQR 4 - 7)。8名患者(44.4%)无需入住重症监护室。恢复口服的中位时间为 34 天(IQR 26 - 54)。EVT 治疗的成功率为 88.9%。结论 EVT 是治疗食管胃手术 AL 的有效工具。尽管治疗时间可能较长,但在该系列中的成功率为 88.9%,而且在某些病例中可以避免入住重症监护室。必须对这类患者进行密切监测,并及时使用其他技术确保源头控制。
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来源期刊
Diseases of the Esophagus
Diseases of the Esophagus 医学-胃肠肝病学
CiteScore
5.30
自引率
7.70%
发文量
568
审稿时长
6 months
期刊介绍: Diseases of the Esophagus covers all aspects of the esophagus - etiology, investigation and diagnosis, and both medical and surgical treatment.
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